PTSD symptom profiles among Louisiana women affected by the 2010 Deepwater Horizon Oil Spill: A latent profile analysis

• Published in: Journal of affective disorders 2019-05, Vol.250, p.289-297
• Main Authors: Nugent, Nicole, Gaston, Symielle A., Perry, Jacqueline, Rung, Ariane L., Trapido, Edward J., Peters, Edward S.
• Format: Article
• Language: English
• Subjects: Adult; Comorbidity; Depression - diagnosis; Depression - etiology; Depression - psychology; Diagnostic and Statistical Manual of Mental Disorders; Disaster victims; Female; Humans; Louisiana; Male; Maternal Exposure - adverse effects; Mental Health; Middle Aged; Petroleum Pollution - adverse effects; Post-traumatic stress disorders; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - etiology; Stress Disorders, Post-Traumatic - psychology; Symptom Assessment; Women; Women's Health
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2019.03.018

•Latent profile analysis of the PCL-5 supported five distinct PTSD classes.•Women with a low-symptom profile had fewer traumas and socioeconomic risk factors.•Women with severe PTSD symptoms had more traumas and socioeconomic risk factors.•Most women with severe PTSD symptoms had no prior PTSD diagnosis. Few prior studies have investigated the latent class structure of PTSD using DSM-5 symptoms. To describe latent PTSD profiles among women who resided in Deepwater Horizon Oil Spill (DHOS)-affected coastal Louisiana communities, we used data from women enrolled in The Women and Their Children's Health (WaTCH) Study. Latent profile analysis was performed on the 20-item PTSD Checklist for DSM-5 (PCL-5) and model fit statistics for 2-class through 6-class solutions were compared. The pseudo-class draws method was employed on the best class solution to compare key covariates (including demographics, mental health indicators, DHOS exposure indicators, and trauma exposures) across classes. Among 1997 women (mean age 46.63 ± 12.14 years, 56.8% white, mean trauma categories 6.09 ± 2.98, 9.55% previously diagnosed with PTSD), model fit statistics supported a five-class solution: low symptoms (mean PCL-5 = 4.10), moderate without mood alterations (mean = 19.73), moderate with mood alterations (mean = 34.24), severe without risk-taking (mean = 55.75), and severe with risk-taking (mean = 53.80). Women in the low-symptom class were significantly more likely to be white, have finished high school, have an income of at least $40,001 per year, be married or living with a partner, and endorse fewer trauma categories than women in the four symptomatic classes. Women with moderate to severe symptoms often had co-morbid depressive symptoms and no prior PTSD diagnosis. This study was limited by use of self-reported data and one-time assessment of PTSD symptoms. Five distinct latent profiles of DSM-5 PTSD symptoms consisted of notably different individuals. Most affected women did not report prior PTSD diagnosis. Future research and practice identifying and addressing barriers to care for trauma-affected women in these communities is warranted.