Identifying post-traumatic stress symptom typologies in clinical and non-clinical healthcare staff : a latent profile analysis

Background: There has been growing concern regarding increasing levels of post-traumatic stress (PTS) symptoms experienced by healthcare workers (HCW) in the UK, particularly following the COVID-19 pandemic.

Objectives: PTS symptom typologies have been investigated in other adult populations using person-centred latent variable approaches, revealing profiles showing differing symptom levels and patterns. We aimed to explore typologies among clinical and non-clinical healthcare staff to elucidate heterogeneity of presentation.  

Methods: This was a retrospective study using referral data from treatment-seeking healthcare staff in the North of England (N = 1600). We employed latent profile analysis using the PTSD International Trauma Questionnaire domains as profile indicators. We included covariates relating to role-type, depression, anxiety and mental health concerns before March of 2020.   

Results: A model with six profiles fit the data best. Profile names were given as follows: ‘No symptom’; ‘Low symptom’; ‘Low symptom (moderate Sense of current threat (Th_dx) and Functional impairment (FI))’; ‘Moderate symptom (low Th_dx and high Avoidance (Av_dx))’; ‘Moderate symptom’; and ‘High symptom’. Covariates were shown to have differential predictive power on profile membership. 

Conclusions: The finding of profiles with pattern differences suggests a need for both differential and specifically targeted treatments, as well as a consideration of early intervention for those individuals with subclinical PTS symptoms. As expected, anxiety and depression were both predictors of several of the symptomatic profiles, with anxiety producing a larger effect. Further research is required to fully understand the link between role-type and PTS symptom typologies among HCW. 

HIGHLIGHTS

• Six distinct profiles of post-traumatic stress symptoms were found in treatment-seeking healthcare staff.
• Four of the profiles differed only in terms of severity of symptoms. Two of the profiles revealed pattern differences relating to differing severity across avoidance, sense of current threat and functional impairment.
• Working in a non-clinical role (e.g. hospital porter or admin staff) predicted membership of two of the moderate symptom profiles.
• Other mental health difficulties, anxiety and depression, predicted membership of several symptomatic profiles.