Kofman Yasmin B, Brown Joni, Dunkel Schetter Christine, Sumner Jennifer A
Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA.
Psychol Med. 2025 Jan 14;54(16):1-12. doi: 10.1017/S0033291724002915.
Racial, ethnic, and socioeconomic disparities persist in posttraumatic stress disorder (PTSD), which are partly attributed to minoritized women being trauma-exposed, while also contending with harmful contextual stressors. However, few have used analytic strategies that capture the interplay of these experiences and their relation to PTSD. The current study used a person-centered statistical approach to examine heterogeneity in trauma and contextual stress exposure, and their associations with PTSD and underlying symptom dimensions, in a diverse sample of low-income postpartum women.
Using a community-based sample of Black, Hispanic/Latina, and White postpartum women recruited from five U.S. regions ( = 1577), a latent class analysis generated profiles of past-year exposure to traumatic events and contextual stress at one month postpartum. Regression analyses then examined associations between class membership and PTSD symptom severity at six months postpartum as a function of race/ethnicity.
A four-class solution best fit the data, yielding High Contextual Stress, Injury/Illness, Violence Exposure, and Low Trauma/Contextual Stress classes. Compared to the Low Trauma/Contextual Stress class, membership in any of the other classes was associated with greater symptom severity across nearly all PTSD symptom dimensions (all < 0.05). Additionally, constellations of exposures were differentially linked to total PTSD symptom severity, reexperiencing, and numbing PTSD symptoms across racial/ethnic groups ( < 0.05).
A person-centered approach to trauma and contextual stress exposure can capture heterogeneity of experiences in diverse, low-income women. Moreover, racially/ethnically patterned links between traumatic or stressful exposures and PTSD symptom dimensions have implications for screening and intervention in the perinatal period.
创伤后应激障碍（PTSD）中存在种族、族裔和社会经济差异，部分原因是少数族裔女性遭受创伤，同时还要应对有害的环境压力源。然而，很少有人使用分析策略来捕捉这些经历之间的相互作用及其与PTSD的关系。本研究采用以个体为中心的统计方法，在低收入产后女性的多样化样本中，研究创伤和环境压力暴露的异质性，以及它们与PTSD及其潜在症状维度的关联。
采用基于社区的样本，从美国五个地区招募了黑人、西班牙裔/拉丁裔和白人产后女性（n = 1577），通过潜在类别分析生成产后一个月过去一年创伤事件暴露和环境压力的概况。然后进行回归分析，以种族/族裔为函数，研究类别归属与产后六个月PTSD症状严重程度之间的关联。
四类解决方案最符合数据，产生了高环境压力、受伤/疾病、暴力暴露和低创伤/环境压力类别。与低创伤/环境压力类别相比，其他任何类别的成员在几乎所有PTSD症状维度上的症状严重程度都更高（所有p < 0.05）。此外，不同种族/族裔群体的暴露组合与PTSD总症状严重程度、再次体验和麻木PTSD症状存在差异关联（p < 0.05）。
以个体为中心的创伤和环境压力暴露方法可以捕捉不同低收入女性经历的异质性。此外，创伤性或应激性暴露与PTSD症状维度之间的种族/族裔模式联系对围产期的筛查和干预具有启示意义。
