Identifying a PTSD resilient group based on a latent class analysis of childhood trauma and adult PTSD symptoms Open Access

Abstract

Many people experience traumatic events followed by a range of reactions that subside naturally after a few weeks or months. However, for some people these adverse reactions persist and the person develops posttraumatic stress disorder (PTSD). There is no way to know for sure who will develop PTSD, making this disorder heterogeneous. The goal of this study was to investigate and better understand the structure of heterogeneity in PTSD based on reported childhood trauma and current PTSD symptoms using latent class analysis (LCA). A large sample of civilian subjects were recruited from an urban hospital in Atlanta, GA. LCA were conducted on data collected from an early cohort of participants using 25-item childhood trauma questionnaire (CTQ) and 17-item modified PTSD symptom scale (PSS) to identify classes of PTSD. Due to the large sample size, robustness of the latent classes was evaluated using a recently collected, independent group of participants. To better understand the heterogeneity between classes, resilience and affect differences between classes were analyzed. LCA on the early cohort of 3940 subjects suggested four classes provided the best fit with meaningful, distinct classes characterized as: 1. Low childhood trauma, high PTSD symptoms; 2. High childhood trauma, high PTSD symptoms; 3. Moderate childhood trauma, low PTSD symptoms; 4. Low childhood trauma, low PTSD symptoms. LCA on the recently collected cohort of 1299 subjects replicated this finding with the same four classes suggesting these results as robust. Among the four classes, Class 3 experienced childhood trauma and yet had low PTSD symptoms, highlighting this group as psychologically resilient to PTSD. In comparison to Classes 1 and 2, who had high PTSD symptoms, Class 3 was less negative and depressed and had higher resilience measures compared to Class 2. It merits future studies to further confirm the existence of a psychologically resilient group, and to develop tools to identify such a group that implies persons at lower risk for PTSD.

Table of Contents

1 Introduction

2 Methods

2.1 Participants

2.2 Clinical Assessments

2.3 Statistical Analysis

2.3.1 Latent Class Analysis

2.3.2 Testing differences between Classes

3 Results

3.1 Robustness of Latent Class Analysis Results

3.2 Classes of PTSD

3.3 Investigating Class 3: The Resilient Group

4 Discussion

5 Conclusion

References

Appendix A: Tables

Appendix B: Figures

About this Master's Thesis

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School	Laney Graduate School
Department	Biostatistics
Degree	MS
Submission	Master's Thesis
Language	English
Research Field	Statistics Health Sciences, Mental Health
Keyword	LCA Resilient Posttraumatic stress disorder PTSD
Committee Chair / Thesis Advisor	Manatunga, Amita, Emory University
Committee Members	Peng, Limin, Emory University Guo, Ying, Emory University

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