Latent Classes of Childhood Poly-victimization and Associations with Suicidal Behavior among Adult Trauma Victims: Moderating Role of Anger

The aims of the present study were first to identify discrete patterns of childhood victimization experiences including crime, child maltreatment, peer/sibling victimization, sexual violence, and witnessing violence among adult trauma victims using latent class analysis; second, to examine the association between class-membership and suicidal behavior, and third to investigate the differential role of dispositional anger on the association between class-membership and suicidal behavior. We hypothesized that those classes with accumulating exposure to different types of childhood victimization (e.g., poly-victimization) would endorse higher suicidal behavior, than the other less severe classes, and those in the most severe class with higher anger trait would have stronger association with suicidal behavior. Respondents were 346 adults (N = 346; Mage = 35.0 years; 55.9% female) who had experienced a lifetime traumatic event. Sixty four percent had experienced poly-victimization (four or more victimization experiences) and 38.8% met the cut-off score for suicidal behavior. Three distinct classes emerged namely, the Least victimization (Class 1), the Predominantly crime and sibling/peer victimization (Class 2), and the Poly-victimization (Class 3) classes. Regression analysis controlling for age and gender indicated that only the main effect of anger was significantly associated with suicidal behavior. The interaction term suggested that those in the Poly-victimization class were higher on suicidal behavior as a result of a stronger association between anger and suicidal behavior in contrast to the association found in Class 2. Clinical implications of findings entail imparting anger management skills to facilitate wellbeing among adult with childhood poly-victimization experiences

Assessment of the revised Difficulties in Emotion Regulation Scales among adolescents and adults with severe mental illness

The Difficulties in Emotion Regulation Scale (DERS) comprising 36 items has been widely used across age, gender, psychopathology, language, and culture. Recently several alternative abridged forms have been introduced, namely, the DERS-16 (Bjureberg et al. 2016), the DERS-SF (Kaufman et al. 2016), and the DERS-18 (Victor and Klonsky, 2016), each composed of 16 or 18 items, to provide researchers and clinicians with a shorter measure of emotion dysregulation. However, no study to date has directly compared the psychometrics of these alternative forms. In the present study, using confirmatory factor analysis we first examined the factor structure of the four models of the DERS in two inpatient samples of 636 adolescents in the age-range of 12–17 years (M = 15.33, SD = 1.43), and 1807 adults in the age-range of 18–76 years (M = 34.86, SD = 14.63) with severe mental illness. Next, measurement invariance was tested comparing the two age groups across the four models of DERS. Only the DERS-SF established metric and scalar measurement invariance. Findings suggest that the factor structure of the original and the abridged models of DERS have acceptable fit, however only DERS-SF had equivalence of factor loadings and item intercepts across adolescents and adults

Latent profile analysis of PTSD and dissociation, and relations with anger

Demographic and traumatic event-related risk factors for PTSD and dissociative symptoms have been examined in prior research. However, less research has examined this issue from a person-centered statistical approach to report subgroups of clinical presentations identified based on endorsed symptoms. The present study examined the relationship between PTSD, dissociation, and anger using this approach. We utilized a sample (N = 360) of trauma-exposed adults recruited via Amazon&#39;s Mechanical Turk. Latent profile analysis (LPA) identified distinct profiles based on the indicators of PTSD subscale scores and a dissociation total score. The following latent profiles were identified: 1) low PTSD/low dissociation, 2) moderate PTSD/moderate dissociation, and 3) high PTSD/high dissociation. Additional analyses found differential relationships between the three profiles and anger, with individuals in the high PTSD/high dissociation profile exhibiting more anger. Results shed light on the high co-occurrence between anger and PTSD symptoms.</p

Anger as an underlying dimension of posttraumatic stress disorder

In this study, we examined the underlying role of anger in posttraumatic stress disorder (PTSD). Although anger is currently considered within two symptoms of PTSD (i.e., anger/irritability; and negative emotional state), some research has found that anger is more than just a diagnostic symptom of PTSD. The sample consisted of 375 trauma-exposed individuals that completed the PTSD Checklist-5 and Dimensions of Anger Reactions Scale. Confirmatory factor analysis was used to assess PTSD's factor structure based on the four-factor DSM 5 PTSD model. Subsequently, the model was re-tested, statistically controlling for anger by regressing PTSD's items on an observed anger score. Individual factor loading differences were then compared to determine anger's underlying role. Results indicated that a significant amount of variance in PTSD, at both the item level and factor level, was attributable to an underlying dimension of anger. The largest factor attenuation was for the symptom of irritability/anger and the smallest attenuation was recklessness. The results suggest that anger underlies more of PTSD than the two diagnostic symptom criteria

Hispanic ethnicity and Caucasian race: Relations with posttraumatic stress disorder\u27s factor structure in clinic-referred youth.

The severity of posttraumatic stress disorder (PTSD) symptoms is linked to race and ethnicity, albeit with contradictory findings (reviewed in Alcántara, Casement, & Lewis-Fernández, 2013; Pole, Gone, & Kulkarni, 2008). We systematically examined Caucasian (n = 3,767) versus non-Caucasian race (n = 2,824) and Hispanic (n = 2,395) versus non-Hispanic ethnicity (n = 3,853) as candidate moderators of PTSD\u27s 5-factor model structural parameters (Elhai et al., 2013). The sample was drawn from the National Child Traumatic Stress Network\u27s Core Data Set, currently the largest national data set of clinic-referred children and adolescents exposed to potentially traumatic events. Using confirmatory factor analysis, we tested the invariance of PTSD symptom structural parameters by race and ethnicity. Chi-square difference tests and goodness-of-fit values showed statistical equivalence across racial and ethnic groups in the factor structure of PTSD and in mean item-level indicators of PTSD symptom severity. Results support the structural invariance of PTSD\u27s 5-factor model across the compared racial and ethnic groups. Furthermore, results indicated equivalent item-level severity across racial and ethnic groups; this supports the use of item-level comparisons across these groups