Departments of Pediatrics and Psychiatry and Human Behavior, Brown University Warren Alpert School of Medicine, Providence, RI, United States.
Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States.
J Affect Disord. 2019 May 1;250:289-297. doi: 10.1016/j.jad.2019.03.018. Epub 2019 Mar 6.
Few prior studies have investigated the latent class structure of PTSD using DSM-5 symptoms.
To describe latent PTSD profiles among women who resided in Deepwater Horizon Oil Spill (DHOS)-affected coastal Louisiana communities, we used data from women enrolled in The Women and Their Children's Health (WaTCH) Study. Latent profile analysis was performed on the 20-item PTSD Checklist for DSM-5 (PCL-5) and model fit statistics for 2-class through 6-class solutions were compared. The pseudo-class draws method was employed on the best class solution to compare key covariates (including demographics, mental health indicators, DHOS exposure indicators, and trauma exposures) across classes.
Among 1997 women (mean age 46.63 ± 12.14 years, 56.8% white, mean trauma categories 6.09 ± 2.98, 9.55% previously diagnosed with PTSD), model fit statistics supported a five-class solution: low symptoms (mean PCL-5 = 4.10), moderate without mood alterations (mean = 19.73), moderate with mood alterations (mean = 34.24), severe without risk-taking (mean = 55.75), and severe with risk-taking (mean = 53.80). Women in the low-symptom class were significantly more likely to be white, have finished high school, have an income of at least $40,001 per year, be married or living with a partner, and endorse fewer trauma categories than women in the four symptomatic classes. Women with moderate to severe symptoms often had co-morbid depressive symptoms and no prior PTSD diagnosis.
This study was limited by use of self-reported data and one-time assessment of PTSD symptoms.
Five distinct latent profiles of DSM-5 PTSD symptoms consisted of notably different individuals. Most affected women did not report prior PTSD diagnosis. Future research and practice identifying and addressing barriers to care for trauma-affected women in these communities is warranted.
使用 DSM-5 症状研究创伤后应激障碍（PTSD）的潜在类别结构的先前研究较少。
为了描述居住在深海地平线石油泄漏（DHOS）受灾沿海路易斯安那州社区的妇女的潜在 PTSD 特征，我们使用了参加妇女及其子女健康研究（WaTCH）的妇女的数据。对 20 项 PTSD 检查表 DSM-5（PCL-5）进行潜在特征分析，并比较了 2 类至 6 类解决方案的模型拟合统计数据。在最佳类别解决方案上采用伪类绘图方法，比较类别之间的关键协变量（包括人口统计学，心理健康指标，DHOS 暴露指标和创伤暴露）。
在 1997 名妇女（平均年龄 46.63 ± 12.14 岁，56.8％为白人，平均创伤类别为 6.09 ± 2.98，9.55％先前被诊断为 PTSD）中，模型拟合统计数据支持五类别解决方案：低症状（平均 PCL-5 = 4.10），中度无情绪改变（平均 = 19.73），中度伴有情绪改变（平均 = 34.24），严重无冒险行为（平均 = 55.75）和严重冒险行为（平均 = 53.80）。低症状类别的妇女更有可能是白人，高中毕业后，收入至少为每年 40,001 美元，已婚或与伴侣同住，并且比四类有症状的妇女认同更少的创伤类别。中度至重度症状的妇女通常伴有共病抑郁症状，且无先前 PTSD 诊断。
本研究仅限于使用自我报告的数据和一次 PTSD 症状评估。
DSM-5 PTSD 症状的五个不同潜在特征包括明显不同的个体。大多数受影响的妇女没有报告先前的 PTSD 诊断。需要进一步研究和实践，以确定和解决这些社区中受创伤妇女的护理障碍。
