What can we learn about polytrauma typologies by comparing population-representative to trauma-exposed samples: A Nepali example

Sabrina Hermosilla; Karmel W Choi; Melanie S Askari; Taylor Marks; Christy Denckla; William Axinn; Jordan W Smoller; Dirgha Ghimire; Corina Benjet

doi:10.1016/j.jad.2022.07.006

What can we learn about polytrauma typologies by comparing population-representative to trauma-exposed samples: A Nepali example

J Affect Disord. 2022 Oct 1:314:201-210. doi: 10.1016/j.jad.2022.07.006. Epub 2022 Jul 8.

Authors

Sabrina Hermosilla¹, Karmel W Choi², Melanie S Askari³, Taylor Marks³, Christy Denckla⁴, William Axinn³, Jordan W Smoller², Dirgha Ghimire⁵, Corina Benjet⁶

Affiliations

¹ Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, USA. Electronic address: shermosi@umich.edu.
² Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA.
³ Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, USA.
⁴ Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
⁵ Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, USA; Institute for Social and Environmental Research-Nepal, Chitwan, Nepal.
⁶ Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.

Abstract

Background: Potentially traumatic events (PTEs) are common and associated with detrimental outcomes over the life-course. Previous studies exploring the causes and consequences of PTE-exposure profiles are often from high-income settings and fail to explore the implications of sample selection (i.e., population-representative versus PTE-restricted).

Methods: Among individuals in the Nepal Chitwan Valley Family Study, latent class analyses (LCA) were performed on 11 self-reported PTEs collected by the Nepali version of the World Mental Health Consortium's Composite International Diagnostic Interview 3.0 from 2016 to 2018, in a population-representative sample (N = 10,714), including a PTE-restricted subsample (N = 9183). Multinomial logistic regressions explored relationships between sociodemographic factors and class membership. Logistic regressions assessed relationships between class membership and psychiatric outcomes.

Results: On average, individuals were exposed to 2 PTEs in their lifetime. A five-class solution showed optimal fit for both samples; however, specific classes were distinct. No single sociodemographic factor was universally associated with PTE class membership in the population-representative sample; while several factors (e.g., age, age at incident PTE, education, marital status, and migration) were consistently associated with class membership in the PTE-subsample. PTE class membership differentiated psychiatric outcomes in the population-representative sample more than the PTE-subsample.

Limitations: Primary limitations are related to the generalizability to high-income settings, debate on LCA model fit statistic usage for final class selection, and cross-sectional nature of data collection.

Conclusions: Although population-representative samples provide information applicable to large-scale, population-based programming and policy, PTE-subsample analyses may provide additional nuance in PTE profiles and their consequences, important for specialized prevention efforts.

Keywords: Global mental health; Latent class analysis; Trauma.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Humans
Life Change Events
Mental Health
Multiple Trauma* / psychology
Stress Disorders, Post-Traumatic* / psychology

Abstract

Publication types

MeSH terms

Grants and funding