A latent class analysis of dissociative PTSD subtype among Chinese adolescents following the COVID-19 pandemic and lockdown

Yajie Bi; Chengqi Cao; Ruojiao Fang; Na Wang; Ping Liu; Shu Luo; Emma Grace; Li Wang

doi:10.1016/j.jad.2023.12.078

A latent class analysis of dissociative PTSD subtype among Chinese adolescents following the COVID-19 pandemic and lockdown

J Affect Disord. 2024 Mar 15:349:596-603. doi: 10.1016/j.jad.2023.12.078. Epub 2024 Jan 8.

Authors

Yajie Bi¹, Chengqi Cao², Ruojiao Fang², Na Wang², Ping Liu³, Shu Luo³, Emma Grace⁴, Li Wang⁵

Affiliations

¹ Department of Psychosomatics, People's Hospital of Deyang City, Deyang, Sichuan Province, China; School of Psychology, Guizhou Normal University, Guiyang, Guizhou Province, China; Sichuan Clinical Research Center for Neurological Disease, Deyang, Sichuan Province, China.
² Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
³ Department of Psychosomatics, People's Hospital of Deyang City, Deyang, Sichuan Province, China; Sichuan Clinical Research Center for Neurological Disease, Deyang, Sichuan Province, China.
⁴ Department of International Psychology, The Chicago School of Professional Psychology, Washington, DC, USA.
⁵ Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; School of Psychology, Guizhou Normal University, Guiyang, Guizhou Province, China. Electronic address: wangli1@psych.ac.cn.

PMID: 38199423
DOI: 10.1016/j.jad.2023.12.078

Abstract

Background: The COVID-19 pandemic and related policies have amplified the vulnerability of adolescents to the development of posttraumatic stress disorder (PTSD) and dissociation symptoms. This study sought to explore the profile patterns and psychopathological characteristics of co-occurring PTSD and dissociation symptoms in Chinese adolescents.

Methods: A total of 57,984 junior and senior high school students in Deyang City, China were recruited between July 13 and July 19, 2020. PTSD and dissociation symptoms, risk factors, and functional impairment variables were assessed using the Global Psychotrauma Screen for Teenagers (GPS-T) instrument. Latent class analysis (LCA) was employed to examine the phenomenology and risk factors of co-occurring PTSD and dissociation symptoms. Analysis of Variance (ANOVA) was utilized to investigate differences in COVID-19 pandemic-related exposure and functional impairment across distinct symptom profiles.

Results: A 4-class model was selected as the optimal solution, comprising subgroups of low symptom, predominant PTSD symptom, predominant dissociation symptom, and PTSD-dissociation symptom. Class membership could be significantly predicted by other stressful experiences, social support, childhood maltreatment and psychiatric histories. The PTSD-dissociation symptom class exhibited the most severe COVID-19 pandemic-related exposure and functional impairment among all classes.

Limitations: The cross-sectional design, Chinese cultural background, online survey method and oversimple measurements were the limitations.

Conclusions: Our findings extend existing knowledge about the coexisting patterns of PTSD and dissociation symptoms in adolescents, which could assist in identifying high-risk youths. Furthermore, our findings offer recommendations for shaping public health policies and formulating effective clinical interventions for adolescents following the COVID-19 pandemic and lockdown.

Keywords: Adolescents; COVID-19; Dissociation; Latent class analysis; Post-traumatic stress disorder.

MeSH terms

Adolescent
COVID-19* / epidemiology
China / epidemiology
Communicable Disease Control
Cross-Sectional Studies
Dissociative Disorders / psychology
Humans
Latent Class Analysis
Pandemics
Stress Disorders, Post-Traumatic* / psychology