Characterizing Typologies of Polytraumatization: A Replication and Extension Study Examining Internalizing and Externalizing Psychopathology in an Urban Population

• Type of Material: Article
• Authors: Yara Mekawi, Emory University; Eva Kuzyk, Emory University; Drew H Dixon, Emory University; Brooke McKenna, Emory University; Luisa Camacho, Emory University; Ana Martinez de Andino, Emory University; Jennifer Stevens, Emory University; Vasiliki Michopolous, Emory University; Abigail Powers, Emory University
• Language: English
• Date: 2021-05-19
• Publisher: SAGE PUBLICATIONS INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © The Author(s) 2021.
• Final Published Version (URL): http://dx.doi.org/10.1177/21677026211000723
• Title of Journal or Parent Work: CLINICAL PSYCHOLOGICAL SCIENCE
• Volume: 9
• Issue: 6
• Start Page: 1144
• End Page: 1163
• Grant/Funding Information: This work was supported by the National Institute of Mental Health (MH071537; MH100122; MH102890), the National Institute of Child Health and Human Development (HD071982), and the National Center for Complementary & Integrative Health (K23AT009713).
• Keywords: Psychiatry; Life Sciences & Biomedicine; Psychology, Clinical; minority groups; LATENT CLASS ANALYSIS; MENTAL-HEALTH; posttraumatic stress disorder; CHILDHOOD MALTREATMENT; PSYCHOLOGICAL DISTRESS; PSYCHOMETRIC PROPERTIES; LIFE EVENTS; ABUSE SCREENING-TEST; trauma; Science & Technology; depression; POSTTRAUMATIC-STRESS-DISORDER; Psychology; Social Sciences; aggressive behavior; INTIMATE PARTNER VIOLENCE; TRAUMA EXPOSURE

Abstract

A person-centered approach to examining trauma has uncovered typologies of polytraumatization that are differentially associated with psychopathology. However, previous research is limited by narrow conceptualizations of trauma, limited distal outcomes, and underrepresentation of racially marginalized groups. To address these gaps, we used latent profile analysis to uncover distinct polytraumatization typologies and examine four symptom-based (posttraumatic stress disorder, depression, aggression, and substance abuse) and two behavior-based (self-harm, jail counts) outcomes in a sample of adults with low socioeconomic resources (N = 7,426, 94% African American). The models were indicated by 19 traumatic experiences (e.g., accident, sexual assault, witnessing/experiencing violence). The best fitting model uncovered five classes: minimal trauma, physical abuse, violence exposure, sexual abuse, and polytrauma. Classes characterized by significant and varied trauma were higher on both internalizing and externalizing psychopathology, whereas those characterized by specific types of trauma were higher on only one type of psychopathology. Implications for the assessment and treatment of trauma-related disorders are discussed.