(PS10-39) Structural models of trauma severity: An evaluation of objective, subjective, and novel indicators

Abstract Text:

Background: Whereas changes to the definition of trauma for posttraumatic stress disorder (PTSD) criteria have attempted to refine the boundaries of a qualifying event, methods for quantifying the severity of a traumatic experience have received notably less attention. Trauma severity can be broadly defined as the intensity of a qualifying event or events, with conceptual models assuming a dose-response relation between severity and posttrauma outcomes. However, existing research is limited by a lack of consistency in the conceptualization and assessment of trauma severity as a formal psychological construct. Common indicators of severity include objective severity (i.e., duration, type of exposure, injury severity), subjective severity (i.e., peritraumatic responses), and frequency of exposure. Other proposed markers include event centrality (i.e., the extent to which an experience serves as a marker in identity and/or life story) and acute disruption (i.e., immediate changes in typical, daily routines following trauma exposure). The aims of the current study are to (a) determine the extent to which various indicators of event severity form a cohesive structure and (b) examine the relations between aspects of event severity and subsequent post-trauma outcomes (e.g., PTSD, depression, functioning).

Method: Participants include university undergraduates reporting exposure to probable traumatic events (projected N = 200). Following the completion of a validated screener, individuals reporting qualifying events (e.g., sexual assault, physical abuse, traumatic accidents) are invited to enroll in the larger project. Those completing the larger online study will complete a modified version of the Trauma History Screen (THS) in addition to measures of event centrality, functional impairment, depression, and PTSD. Structural equation modeling will be used to assess the fit of the proposed dimensions of objective severity, subjective severity, repeated exposure, centrality, and acute disruption to both a correlated factor solution as well as an alternative hierarchical model specifying a higher-order dimension of global event severity. Following the identification of a preferred solution, path analyses will be used to test unique effects of severity dimensions with indices of PTSD symptom severity, depression, and current functioning.

Results: Data collection is ongoing (n = 59; 75% female; 88% White) with the full sample to be completed by Summer 2025. Index events in the current sample include sexual assault (37%), violent or accidental death of close family/friend (24%), motor vehicle accident (12%), witnessing death (12%), physical assault (10%), natural disaster (3%), and other non-transportation accidents (2%). Trauma symptoms reported in current participants are modest with a high degree of variability (PCL-5; M = 20.3, SD = 19.7). Results of this research are intended to provide an initial test for the viability of a comprehensive model, with the broad goal of incorporating a novel understanding of trauma severity into the literature to be examined further.