Reactions to Trauma Over Time: Trajectories of Post-Traumatic Stress Disorder Symptoms in Survivors of Violent Crime.

Abstract

Although experiencing crime is a common source of trauma, it remains unclear how the impact of violent crime translates into trajectories of post-traumatic stress disorder (PTSD) symptoms following treatment. The purpose of the present study was to identify the proportion of survivors of violent crime whose PTSD symptoms remained clinically significant over time and assess their characteristics to inform treatment. The first objective of this study was to determine the trajectories of PTSD symptoms in survivors of violent crime. The second objective was to assess the demographic, trauma-related and psychological risk factors that characterise the trajectories of PTSD symptoms. One hundred eighty-six survivors of violent crime were recruited at a trauma study centre and assigned to either a cognitive behavioural therapy treatment or control group. The participants' PTSD symptoms were measured within 2 weeks, 2 months and 6 months after their traumatic event. Group-based trajectory modelling was carried out to determine the development of PTSD symptoms over time. Three trajectories were found. A low initial symptoms trajectory with moderate improvement (34.9%), one with high initial symptoms that showed significant improvement (44.6%), and one with high initial symptoms that showed no improvement (20.5%). Trajectories were associated with demographic and psychological risk factors; these included comorbid anxiety and unemployment. The participants' PTSD symptoms followed three distinct trajectories, and trajectory membership was most strongly linked to comorbid psychological conditions and socioeconomic indicators.