Effect of the interplay between trauma severity and trait neuroticism on posttraumatic stress disorder symptoms among adolescents exposed to a pipeline explosion

Abstract

Background: While numerous studies have explored relevant factors of posttraumatic stress disorder (PTSD) symptoms, there have been few joint investigations of trauma severity and trait neuroticism on the development of PTSD symptoms. This study aims to assess the involvement and interrelationship of trauma severity and neuroticism in the expression of PTSD symptoms among adolescents exposed to an accidental explosion.

Methods: Six hundred and sixty-two adolescents were recruited from a junior middle school closest to the 2013 pipeline explosion site in China and were assessed using the Explosion Exposure Questionnaire, the NEO Five Factor Inventory-Neuroticism Subscale (FFI-N), and the PTSD Checklist-Civilian (PCL-C). A battery of hierarchical multiple regression analyses and two-way ANOVAs were performed to examine the effect of trauma severity and trait neuroticism on adolescent PTSD symptoms.

Results: Eighty-seven adolescents (13.1%) showed PTSD symptoms after the pipeline explosion. Correlation analysis showed that all the factors of explosion exposure and trait neuroticism were positively associated with adolescent PTSD symptoms. Being male and younger was linked to lower risk for PTSD symptoms. The regression models identified explosion exposure and neuroticism as independent risk factors for PTSD symptoms, and the interactions between trait neuroticism and trauma exposure (personal casualty, degree of influence, total traumatic severity) were related to PTSD symptoms.

Conclusions: The results highlight the role of trauma exposure and trait neuroticism as risk factors for PTSD symptoms. Therefore, the combination of these two factors should be investigated in clinical settings due to an augmented risk for more severe PTSD symptoms.

Fig 1. PTSD symptoms: Personal casualty×Trait neuroticism.

This figure presents a two-way ANOVA investigating the association of posttraumatic stress disorder (PTSD) symptoms with the interaction between neuroticism scores and the presence of personal casualty. Effect sizes: neuroticism (F = 21.33; P <. 001; partial η ² = 0.031), personal casualty (F = 25.20; P <. 001; partial η ² = 0.037), neuroticism by personal casualty (F = 6.84; P = .009; partial η ² = 0.010). Given similar levels of personal casualty, high neuroticism adolescents had higher PCL-C scores compared to those with low neuroticism. Moreover, the separation of PCL-C scores appeared more pronounced with increasing levels of severity of personal casualty.

Fig 2. PTSD symptoms: Degree of influence×Trait neuroticism.

This figure presents a two-way ANOVA investigating the association of posttraumatic stress disorder (PTSD) symptoms with the interaction between neuroticism scores and degree of influence. Effect sizes: neuroticism (F = 37.40; P <. 001; partial η ² = 0.054), degree of influence (F = 73.35; P <. 001; partial η ² = 0.101), neuroticism by degree of influence (F = 4.49; P = .035; partial η ² = 0.007). Given a similar degree of influence, high neuroticism adolescents had higher PCL-C scores compared to those with low neuroticism. Moreover, the separation of PCL-C scores appeared more pronounced with increasing degree of influence.

Fig 3. PTSD symptoms: Trauma severity×Trait neuroticism.

This figure presents a two-way ANOVA investigating the association of posttraumatic stress disorder (PTSD) symptoms with the interaction between neuroticism scores and trauma severity. Effect sizes: neuroticism (F = 35.49; P <. 001; partial η2 = 0.051), trauma severity (F = 77.13; P <. 001; partial η2 = 0.105), neuroticism by trauma severity (F = 7.70; P = .006; partial η2 = 0.012). Given similar levels of trauma severity, high neuroticism adolescents had higher PCL-C scores compared to those with low neuroticism. Moreover, the separation of PCL-C scores appeared more pronounced with increasing trauma severity.