Patterns of Acute Stress Disorder in a Sample of Blast-Injured Military Service Members: A Latent Profile Analysis

Casey L. Straud, University of Texas Health Science Center at San Antonio
John C. Moring, University of Texas Health Science Center at San Antonio
Willie J. Hale, University of Texas Health Science Center at San Antonio
Chelsea McMahon, University of Texas Health Science Center at San Antonio
Brian A. Moore, Kennesaw State University
Monty T. Baker, Wilford Hall Ambulatory Surgical Center
Richard A. Bryant, UNSW Sydney
Stacey Young-McCaughan, University of Texas Health Science Center at San Antonio
William C. Isler, Wilford Hall Ambulatory Surgical Center
Jose Lara-Ruiz, University of Texas Health Science Center at San Antonio
Cynthia L. Lancaster, University of Nevada
Jim Mintz, University of Texas Health Science Center at San Antonio
Alan L. Peterson, University of Texas Health Science Center at San Antonio

Abstract

Objective: The primary aims of this study were to identify latent profiles of acute stress disorder (ASD) symptoms and to evaluate postconcussive symptom differences across the identified profiles as measured by the Acute Stress Disorder Scale and the Military Acute Concussion Evaluation, respectively. Method: Participants (N = 315) in the current study were predominantly active-duty (75.0%), enlisted (97.8%) males (97.4%) serving in the U.S. Army (87.8%). Approximately, half of the sample reported being married or engaged (51.1%) and was on average 25.94 (SD = 6.31) years old. Participants were referred to the Air Force Theater Hospital, 332nd Air Expeditionary Wing, Joint Base Balad, Iraq, to be evaluated as part of routine clinical assessment for neurocognitive and psychological symptoms following exposure to a blast. Results: A 3-profile solution was identified as the most parsimonious and bestfitting model based on statistical model fit indices. Blast injured service members in Profile 3 had greater ASD total and subscale severity compared to the other 2 subgroups, with effect size estimates largely differing by hyperarousal and reexperiencing symptoms. Furthermore, Profiles 2 and 3 were more likely to demonstrate postconcussive symptoms compared to Profile 1. Conclusions: Findings provide novel information on heterogenous ASD symptom profiles during the acute phase following a blast injury and highlight the relationship between psychological and physical symptoms. Classification of blast-injured service members may help identify at-risk individuals who would benefit from further clinical care and mitigate long-term psychological and neurocognitive issues.