Psychological risk factors that characterize acute stress disorder and trajectories of posttraumatic stress disorder after injury: A study using latent class analysis

E. Visser*, B.L. den Oudsten, P. Lodder, T. Gosens, J. de Vries

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

3 Citations (Scopus)
118 Downloads (Pure)

Abstract

Background
The course and different characteristics of acute and posttraumatic stress disorder (ASD, PTSD) in trauma populations are unclear.

Objective
The aims were to identify longitudinal trajectories of PTSD, to establish a risk profile for ASD and PTSD based on patients’ sociodemographic, clinical, and psychological characteristics, and to study the effect of ASD and dissociation on PTSD during 12 months after trauma.

Method
Patients completed questionnaires after inclusion and at 3, 6, 9, and 12 months afterwards. Trajectories were identified using repeated measures latent class analysis (RMLCA). The risk profile was based on a ranking of importance of each characteristic using Cohen’s d effect sizes and odds ratios. The impact of ASD and dissociation on PTSD was examined using logistic regression analyses.

Results
Altogether, 267 patients were included. The mean age was 54.0 (SD = 16.1) and 62% were men. The prevalence rate of ASD was approximately 21.7% at baseline, and 36.1% of trauma patients exhibited PTSD at 12 months after injury. Five trajectories were identified: (1) no PTSD symptoms, (2) mild, (3) moderate, (4) subclinical, and (5) severe PTSD symptoms. These trajectories seemed to remain stable over time. Compared with patients in other trajectories, patients with ASD and (subclinical) PTSD were younger and scored higher on anxiety, depressive symptoms, neuroticism, and trait anxiety. Regarding dissociation symptoms, inability to recall memories about the event was significantly more present than an altered sense of reality, (105 (40.7%) versus 56 (21.7%), p = .031), although that symptom had the strongest likelihood for PTSD. Patients with dissociation were significantly at risk for PTSD than patients without dissociation (OR = 4.82; 95%CI: 1.91–12.25).

Conclusions
Psychological factors characterized ASD and trajectories of PTSD during 12 months post-trauma. Healthcare providers who are aware of these findings could early identify patients at risk for ASD and PTSD and refer them for patient-centred interventions.

Netherlands Trial Registry number NTR6258
Original languageEnglish
Article number2006502
Number of pages17
JournalEuropean Journal of Psychotraumatology
Volume13
Issue number1
DOIs
Publication statusPublished - 2022

Keywords

  • Acute stress disorder
  • DEPRESSION SCALE
  • DETERMINANTS
  • DISSOCIATIVE SUBTYPE
  • HOSPITAL ANXIETY
  • IMPACT
  • PTSD SYMPTOMS
  • QUALITY-OF-LIFE
  • RESILIENCE
  • TRAUMATIC INJURY
  • VALIDITY
  • injury
  • longitudinal
  • observational prospective cohort
  • posttraumatic stress disorder
  • repeated measures latent class analysis
  • trajectories
  • trauma

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