A Person-Centered Examination of Trauma, Adversity, Distress, and Resilience: the Role of Age/Cohort Membership

Abstract

BACKGROUND: Post-traumatic Stress Disorder (PTSD) represents a significant public health problem involving pronounced adverse psychological comorbidities, physical ailments, and social deficits. Therefore, it is imperative to better understand the relationship between potentially traumatic event (PTE) exposure and stress-related outcomes across the adult lifespan. METHODS: A community sample (N=511) was recruited using Qualtrics Panels and grouped by age/cohort demographics. An Exploratory Factor Analysis (EFA) was first conducted to identify distinct clusters of latent PTE factors based on event exposure and appraisal. These latent factors were then used in a Latent Profile Analysis (LPA) to identify distinct patterns of exposure risk. Finally, age and various trauma-related characteristics were explored as predictors and outcomes of profile membership. RESULTS: EFA revealed four distinct factors of PTEs (Adverse Childhood Experiences, High Intentionality Violence Across the Lifespan, Situational Deprivation, and Low Intentionality/Agency Adversity). These four factors were then used within the LPA model discovering three distinct profiles of risk (Overall Low Risk, Moderately High Risk, and Overall High Risk). Based on this 3-class model, older adults were more likely (4x) to be in the low-risk profile compared to their younger counterparts. The low-risk profile was associated with higher levels of physical and mental wellness, resilience, and distress tolerance, and lower levels of PTSD. There was no significant difference between the moderately-high and overall high-risk profiles, which were associated with lower mental and physical health scores, levels of resilience and distress tolerance, and greater PTSD severity. However, on average, participants within the overall high-risk profile met criteria for PTSD. They displayed low levels of resilience compared to the moderately high-risk group who reported subclinical levels of PTSD and normal levels of resilience. Both high-risk groups were associated with low levels of distress tolerance. IMPLICATIONS: Study findings have the potential to improve predictive vulnerability models based on specific exposures and their subsequent effects, drive tailored interventions and assessments that are developmentally and culturally informed, and both create and mobilize actionable protective resources that can promote resilience in the face of adversity across the adult lifespan. Recommendations are outlined at each level of prevention.