Posttraumatic Stress Disorder (PTSD) Symptom Profiles Among People Who Have Experienced Abuse: Findings From the NESARC-III Study

Abstract

Greater recognition of diversity in psychological responses to traumatic events has led to increased exploration of posttrauma symptom typologies and risk factors for more “complex” presentations.

Objectives: 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.

Method: We analyzed data from 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. 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. Show more