Understanding the relationships between trauma type and individual posttraumatic stress symptoms: a cross-sectional study of a clinical sample of children and adolescents

Background Characteristics of traumatic events may be associated with the level and specific manifestation of posttraumatic stress symptoms (PTSS). This study examined the differences and similarities between overall levels, profiles and networks of PTSS after sexual trauma, domestic violence, community violence, non-interpersonal trauma, sudden loss or serious illness of a loved one, and severe bullying or threats. Methods PTSS were measured in a clinical sample of 4,921 children and adolescents (6-18 years old, M = 14.0, SD = 2.7, 63.7% female) referred to Child and Adolescent Mental Health Services. We compared 95% confidence intervals (CI) for each symptom with 95% CI for overall PTSS within each trauma type (self-reported worst trauma). We also computed cross-sectional networks and searched for differences in networks according to trauma type and overall symptom level. Results The overall frequencies of PTSS were highest following sexual trauma; somewhat lower for domestic violence and severe bullying or threats and lowest after community violence, non-interpersonal trauma and sudden loss or serious illness. Psychological cue reactivity, avoidance and difficulties with sleeping and concentrating were generally among the most frequent symptoms. Sexual trauma, domestic violence and severe bullying or threats were associated with higher frequencies of negative beliefs and persistent negative emotional states. Few differences in symptom networks across trauma type emerged. Conclusion Different types of trauma exposure may be associated with different profiles of symptom frequencies. Knowledge about this may be useful for clinicians and for the movement towards evidence-based personalized psychological treatment.