Trauma symptom patterns in a large sample of military personnel outpatients: Differential relations to trauma exposure, depression, and anxiety symptoms.

Nina Spaegele, Tova Lewin, Anat Talmon*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: Posttraumatic stress disorder (PTSD) results from experiencing or witnessing a traumatic event and is the most common clinical syndrome seen in military personnel. However, each patient experiences the impact of trauma differently exhibiting individual patterns of trauma symptoms. The current study endeavors to investigate individual patterns of trauma symptoms in military personnel and specifically analyze potential linkage and/or relation between blast exposure, anxiety, and depression. Method: We employed a person-centered approach of latent class analysis (LCA) to stratify 594 military personnel outpatients based on their response patterns in the Trauma Symptom Inventory (TSI). Then, we related the resulting clusters to the number of blasts to which they were exposed, as well as to depression (Zung Self-Rating Depression Scale) and anxiety symptom severity (Beck Anxiety Inventory) using one-way analyses of variance with Bonferroni pairwise comparisons. Results: We found three distinct clusters of traumatic symptoms: (a) Atypical response with low overall symptom burden, (b) increased response level and arousal, and (c) severe trauma symptom burden with tension-reduction behaviors. Individuals in Cluster 2 were exposed to significantly more blasts than in Cluster 1. Moreover, individuals in Cluster 3 reported the highest depression and anxiety symptom severities, followed by Cluster 2, followed by Cluster 1. Conclusions: These results suggest heterogeneity among military personnel suffering from trauma and reveal their distinct relations to clinical comorbidities—emphasizing the role of person-centered, tailored approaches in clinical practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved) The analysis stratified 595 military personnel using latent class analysis according to their reported trauma symptoms in the Trauma Symptom Inventory. In doing so, three clusters were delineated: Class 1, who scored high on atypical response but otherwise indicated low overall symptom burden, Class 2, who presented with increased response levels and arousal, and Class 3, who were found to be suffering from severe trauma symptoms coupled with tension-reduction behaviors. Thus, the examination clearly outlines the need for a person-centered approach to precisely understand and clarify complex heterogenous symptom patterns and work toward more effective and holistic interventions.

Original languageEnglish
JournalPsychological Trauma: Theory, Research, Practice, and Policy
StateAccepted/In press - 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 American Psychological Association


  • anxiety
  • depression
  • latent class analysis
  • trauma exposure
  • war trauma


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