Sex specificity in the profiling of trauma history, risk and outcome: a general population study

Research has suggested that incidences of traumatic experience may cluster within the population, suggesting that individuals may suffer from similar, multiple experiences (Menard, 8andeen-Roche, & Chi lcoat, 2004). Also, differences in trauma type and exposure have been shown to exist between the sexes. Given that different traumatic experiences have consistently been shown to influence psychopathological disorders in both males and females (Kessler et al, 1995; Breslau & Wilcox, 2004; Breslau, Chilcoat, Kessler, & Davis, 1999; Tolin & Foa, 2006), the current thesis aimed to identify distinct groups of females and males within the population characterised by unique profiles of trauma hi story. The present research investigated exposure to traumatic events by adopting a 'person centred' latent class approach. Latent class analysis (LCA), multinomial logistic regression analysis, and confirmatory factor analysis (CFA) were utilised to test a series of hypotheses using data from The National Comorbidity Survey. In chapter two, three latent classes of traumatic exposure were identified for both sexes. For females a low risk class, a medium risk class and an interpersonal trauma class were identified; for males a low risk class, a situational trauma class and an interpersonal/violence class were identified. In chapter three multinomial logistic regression analyses were adopted to identify situational, environmental and clinical risk factors associated with each of the six trauma classes. Traumatised females and males had significantly high associations' with parental psychopathology variables, parental behaviour variables, domestic violence and household/loss factors. It appeared that pre-trauma risk factors were significantly related to latent class membership. In chapter four, multinomial logistic regress ion analyses were used to identify associations between each of the latent classes of trauma and a range of psychopathological disorders. Significant associations were found between the male and female trauma classes and all psychopathological disorders. Extremely high associations were evident for diagnoses of psychosis and PTSD. In chapter five confirmatory factor analyses were utilised to investigate the underlying symptom dimensions of PTSD in both sexes. In addition a multiple indicators and multiple causes (MIMIC) model was used to predict variation in the latent dimensions of the King, Leskin, King, and Weathers (1998) PTSD model using the six trauma classes. All trauma classes in each sex had significant associations with each of the symptom dimensions of PTSD. These findings add to the growing body of research supporting associations between diverse traumatic experiences and diverse psychological outcomes. It is recommended that, based on the current findings, clinicians and practitioners should demonstrate care and consideration when evaluating clients who present with trauma. Full trauma histories may afford better opportunities to deliver more successful and informed treatment interventions, while discrimination between the sexes in terms of trauma risk, occurrence and outcome may aid recovery and careEThOS - Electronic Theses Online ServiceGBUnited Kingdo