Person-centered approach to suicide ideation in posttraumatic stress disorder in veterans: a latent profile analysis

TL;DR

This study identifies distinct groups of veterans with PTSD and varying levels of suicide ideation, depression, and agitation using a person-centered approach.

Contribution

The study introduces a novel person-centered method to classify veterans with PTSD based on symptom profiles and suicide ideation.

Findings

Five distinct subpopulations of veterans were identified based on symptom profiles and suicide ideation intensity.

A subpopulation with high agitation but moderate PTSD and depression showed the highest suicide ideation.

Most veterans (43%) had mild symptoms and low suicide ideation.

Abstract

While most research on suicidal ideation (SI) in veterans adopts a variable-oriented perspective, this approach often fails to capture the complex interplay of symptoms and comorbid disorders. We hypothesised that a person-centred approach can identify distinct subpopulations of veterans with varying profiles of SI, PTSD symptoms, depression, and agitation.

To examine whether distinct subpopulations of veterans exists, characterized by different profiles of PTSD severity, depression and agitation, and intensity of SI.

We conducted a cross-sectional study in one big University Hospital Centre in Croatia on the sample of men, war veterans aged 30-65 years, undergoing treatment for chronic PTSD. Latent profiles indicators included the Clinician-Administered PTSD Scale (CAPS), Beck Scale for Suicide Ideation (SSI), Hamilton Depression Rating Scale-17 (HDRS-17) and Corrigan Agitated Behaviour Scale (CABS).

We included 203 male participants with a median age of 47 (IQR 43-45) years. The optimal model, allowing variances of indicators to vary between profiles while constraining covariances to zero, yielded five distinct latent profiles. Notably, the highest SI was found in a subpopulation with elevated CABS scores, but moderate PTSD and depression symptoms (13% of participants). Next in SI intensity were 11% of veterans with severe symptoms across all assessed disorders. Next in SI severity were 21% of veterans with low levels of agitation but high levels of depression. The last two profiles, one with mild symptoms of all assessed disorders (43%) and the other with high agitation (12%), have low SI severity.

Our findings affirm the utility of a person-centred approach in identifying nuanced subpopulations of veterans with diverse symptom profiles related to SI. This stratification can inform targeted interventions, thereby enhancing the efficacy of suicide prevention strategies.

None Declared