Exploring transdiagnostic stress and trauma-related symptoms across the world: a latent class analysis

ABSTRACT

Background: Although trauma exposure is universally prevalent, the ways in which individuals respond to potentially traumatic events vary. Between-country differences have been identified as affecting the development and manifestation of transdiagnostic psychological symptoms, but it remains unclear how stress and trauma-related transdiagnostic symptoms and risk patterns differ based on geographic region.

Objective: To explore whether there are distinct classes of stress and trauma-related transdiagnostic symptoms and to determine predictors of class membership in a global sample.

Method: Participants (N = 8675) from 115 different countries were recruited online between 2020–2022 and completed the Global Psychotrauma Screen, which assesses stress and trauma exposure, related symptoms, and risk factors. A latent class analysis (LCA) was used to identify classes of stress and trauma-related symptoms per world region (African States, Asia-Pacific States, Eastern European States, Latin American and Caribbean States, Western European and Other States, and North America) and the total sample. Likelihood of class membership was assessed based on demographics, characteristics of the potentially traumatic event, and potential risk factors across the world regions.

Results: Similar class compositions were observed across regions. A joint latent class analysis identified three classes that differed by symptom severity (i.e. high, moderate, low). Multinomial logistic regression analyses revealed several factors that conferred greater risk for experiencing higher levels of symptoms, including geographic region, gender, and lack of social support, among others.

Conclusions: Stress and trauma-related symptoms seem to be similarly transdiagnostic across the world, supporting the value of a transdiagnostic assessment.

HIGHLIGHTS

• A latent class analysis of transdiagnostic stress and trauma-related symptoms in a global sample showed high, medium, and low symptom classes.

• Class compositions were similar across global geographic regions.

• Several factors were associated with high symptom class membership globally, including gender, geographic region, and lack of social support.

Antecedentes: aunque la exposición al trauma es universalmente prevalente, las formas en que los individuos responden a eventos potencialmente traumáticos varían. Se ha identificado que las diferencias entre países afectan el desarrollo y la manifestación de los síntomas psicológicos transdiagnósticos, pero permanece sin esclarecer cómo los síntomas transdiagnósticos y patrones de riesgo relacionados con el estrés y el trauma difieren según la región geográfica.

Objetivo: explorar si existen distintas clases de síntomas transdiagnósticos relacionados con el estrés y el trauma y determinar predictores de pertenencia a una clase en una muestra global.

Método: Participantes (N = 8.675) de 115 países diferentes fueron reclutados en línea entre 2020 y 2022 y completaron la Evaluación Global de Psicotrauma, que evalúa la exposición al estrés y al trauma, los síntomas relacionados y los factores de riesgo. Se utilizó un análisis de clases latentes (LCA) para identificar clases de síntomas relacionados con el estrés y el trauma por región del mundo (Estados de África, Estados de Asia y el Pacífico, Estados de Europa del Este, Estados de América Latina y el Caribe, Estados de Europa Occidental y otros, y América del Norte) y la muestra total. La probabilidad de pertenecer a una clase se evaluó en función de la demografía, las características del evento potencialmente traumático y los posibles factores de riesgo en todas las regiones del mundo.

Resultados: Se observaron composiciones de clases similares en todas las regiones. Un análisis conjunto de clases latentes identificó tres clases que diferían según la gravedad de los síntomas (es decir, alta, moderada, baja). Los análisis de regresión logística multinomial revelaron varios factores que conferían un mayor riesgo de experimentar niveles más altos de síntomas, incluida la región geográfica, el género y la falta de apoyo social, entre otros.

Conclusiones: Los síntomas relacionados con el estrés y el trauma parecen ser igualmente transdiagnósticos en todo el mundo, lo que respalda el valor de una evaluación transdiagnóstica.

KEYWORDS:

• Trauma
• latent class analysis
• transdiagnostic symptoms
• cross-country comparison
• risk factors

PALABRAS CLAVE:

• Trauma
• análisis de clases latentes
• síntomas transdiagnósticos
• comparación entre países
• factores de riesgo

Open Scholarship

This article has earned the Center for Open Science badge for Open Data. The data are openly accessible at https://osf.io/c6u3m/

Acknowledgements

This study was made possible by the Paper in a Day (PIAD) initiative as part of the International Society of Traumatic Stress Studies’ 38th Annual Meeting (9–12 November 2022, Atlanta, Georgia). We thank the conference organizing committee, and in particular Dr. Joanne Mouthaan and Dr. Sierra Elizabeth Carter for making PIAD possible; the Department of Psychology at Georgia State University for granting us their space and resources; and the Trauma Data Institute (TDI) for their PIAD sponsorship.

This PIAD project is part of the Global Collaboration on Traumatic Stress, a worldwide network of researchers and clinicians working together on traumatic stress topics of global importance. This study would not be possible without the work of Dr. Miranda Olff and her team for the Global Psychotrauma Screen. We thank them for granting us access to the data.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability

The data, code, and analyses for this study are publicly available at https://osf.io/c6u3m/

Additional information

Funding

Stephanie Haering’s time is supported by a PhD scholarship from ‘Stiftung der Deutschen Wirtschaft’. Christine Bourey’s time is supported by the United States’ National Institute of Mental Health training grant T32MH103210 and T32MH013043.