Prospective Risk Factors for Latent Trauma Symptom Trajectories.
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Posttraumatic stress disorder (PTSD) is a relatively prevalent disorder that carries a severe impact on quality of life. Fortunately, while it is typical for people to experience elevated symptoms following a traumatic event, it is relatively rare for symptoms to maintain for a significant period of time, meaning PTSD is uncommon (Yehuda & McFarlane, 1995). Unfortunately, it is unclear why a minority of people maintain elevated symptoms and whether their reactions are meaningfully different from individuals who could be classified as resilient. If people who maintain elevated symptoms are indeed from a different population, then the ability to identify them pre-trauma and their specific symptom course has the potential to greatly assist prevention and early intervention efforts. Significant conceptual and procedural difficulties exist within the field of trauma response research related to the development and maintenance of symptoms over time. This study uses a prospective approach to overcome some of the past challenges and presents an innovative approach to statistical analysis to improve understanding and prediction of individual trauma reactions over time. 190 Queensland Ambulance Services recruits were followed across five time points using measures of risk factors, from induction through up to nine months after experiencing of a qualifying traumatic event. Growth mixture modeling was used to examine the presence of heterogeneous symptom trajectories and results identified two groups with distinct trajectories - one Low trauma trajectory, which would reflect the typical response and one High trauma trajectory that was indicative of long-term problematic outcomes. The results indicate that; a) pre-trauma risk factors of prior trauma, depression, and negative trauma cognitions and low levels of social support satisfaction were predictive of elevated and chronic trauma reactions, b) the Low trauma group were more likely, than their High trauma counterparts, to experience posttraumatic growth up to nine months after the event, and c) low depression and less negative trauma cognitions are key variables associated with more posttraumatic growth in the Low trauma group, whereas more prior trauma, cognitive rigidity, and less social support satisfaction are key predictors of posttraumatic growth. Results are discussed in relation to identifying individuals at-risk of negative trauma outcomes and prevention interventions.
Thesis (PhD Doctorate)
Doctor of Philosophy in Clinical Psychology (PhD ClinPsych)
School of Psychology
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