Do adding attachment, oppression, cumulative and proliferation trauma dynamics to PTSD Criterion 'a' improve its predictive validity: Toward a paradigm shift?

摘要

The study investigated the predictive validity of Criterion A for PTSD and evaluated a new development-based trauma dynamic non-linear system paradigm that considers global trauma dynamics of accumulation and trauma proliferation. We conducted secondary analyses of two combined samples (clinical sample N = 1048, and non-clinical sample N = 1706) that used measures for trauma and PTSD. We performed a hierarchical regression to test the incremental predictive validity of adding additional stress and trauma types. To test the non-linear dynamics of cumulative trauma and trauma types, we conducted curve estimation regression. We performed path analysis and PROCESS macro to examine the potential mediating roles of these factors in predicting PTSD. We also examined possible gender differences in the path models. Results of the study indicated that adding the non-criterion A traumas of attachment and collective identity trauma types (a non-criterion A stressors) resulted in the increased incremental predictive validity of criterion A over six-fold and fully mediated the effects of Criterion A on PTSD. The non-linear models of the relationship between trauma and PTSD explained over three times the variance explained by the linear model. The path models were found to be strongly invariant across genders. We concluded that adopting a development-based trauma paradigm, and expanding Criterion A in a formula that includes such stressor/ trauma types and their dynamics, should increase its predictive validity and advance our understanding of PTSD etiology and its non-linear dynamics and improve on current prevention and intervention strategies.