Comparison of latent typologies of posttraumatic stress disorder and depression symptoms across military personnel from India and the US

Abstract

Research has identified heterogeneous subgroups of individuals based on posttraumatic stress disorder (PTSD) and depression symptoms. Using data collected from military personnel in India (N = 146) and U.S. (N = 194), we examined (1) the best-fitting latent class solution; (2) multi-group invariance of the class solution; and (3) construct validity of optimal class solution. Results indicated that the optimal 4-class solution differed in severity and severity/type in the India and U.S. samples respectively. With similarity in the optimal number of classes across cultural samples, the meaning/nature of classes differed. In the India sample, anxiety severity predicted the Low Severity Class vs. all other classes, and the Moderately High Severity/High Severity Classes vs. the Moderately Low Severity Class; number of traumas predicted the High Severity Class vs. other classes; and resilience predicted the Moderately Low Severity Class vs. the Moderately High Severity Class. In the U.S. sample, alcohol use predicted the High Severity Class vs. all other classes, and the High Depression-Low PTSD Class vs. the Low Severity Class; rumination significantly predicted the High Severity and High Depression-Low PTSD Classes vs. each of the High PTSD-Low Depression and Low Severity Classes. Thus, meaning and nature of PTSD-depression subgroups may vary culturally; hence, culturally-sensitive interventions need to account for this heterogeneity.

Keywords: Cross-cultural comparison; Depression; Invariance; Latent profile analyses; Posttraumatic stress disorder.

Figure 1.

Latent classes of participants based on PTSD and depression subscale scores (India sample) Note. PCL-5 is PTSD Checklist for DSM-5; PHQ-9 is Patient Health Questionnaire-9; NACM is negative alterations in cognition and mood; AAR is alterations in arousal and reactivity; Class 1 is the Low Severity Class; Class 2 is the Moderately High Severity Class; Class 3 is the Moderately Low Severity Class; Class 4 is the High Severity Class.

Figure 2.

Latent classes of participants based on PTSD and depression subscale scores (U.S sample) Note. PCL-5 is PTSD Checklist for DSM-5; PHQ-9 is Patient Health Questionnaire-9; NACM is negative alterations in cognition and mood; AAR is alterations in arousal and reactivity; Class 1 is the High PTSD-Low Depression Class; Class 2 is the Low Severity Class; Class 3 is the High Severity Class; Class 4 is the High Depression-Low PTSD Class.