Trauma exposure and transdiagnostic distress: Examining shared and posttraumatic stress disorder–specific associations

Abstract

AbstractWe examined transdiagnostic and posttraumatic stress disorder (PTSD)–specific associations with multiple forms of trauma exposure within a nationwide U.S. sample (N = 1,649, 50.0% female) of military veterans overselected for PTSD. A higher‐order Distress factor was estimated using PTSD, major depressive disorder (MDD), and generalized anxiety disorder (GAD) symptoms as indicators. A structural equation model spanning three assessment points over an average of 3.85 years was constructed to examine the unique roles of higher‐order Distress and PTSD‐specific variance in accounting for the associations between trauma exposure, measured using the Life Events Checklist (LEC) and Deployment Risk and Resiliency Inventory Combat subscale (DRRI‐C), and psychosocial impairment. The results suggest the association between trauma exposure and PTSD symptoms was primarily mediated by higher‐order distress (70.7% of LEC effect, 63.2% of DRRI‐C effect), but PTSD severity retained a significant association with trauma exposure independent of distress, LEC: β = .10, 95% CI [.06, .13]; DRRI‐C: β = .11, 95% CI [.07, .14]. Both higher‐order distress, β = .31, and PTSD‐specific variance, β = .36, were necessary to account for the association between trauma exposure and future impairment. Findings suggest that trauma exposure may contribute to comorbidity across a range of internalizing symptoms as well as to PTSD‐specific presentations.