Synergising latent profile analysis and network analysis to elucidate the relationships among emotion dysregulation, post-traumatic stress disorder, dissociation, psychosis, and affective symptoms in individuals with trauma and severe mental illness.

BACKGROUND: Trauma exposure and emotion dysregulation are transdiagnostic risk factors for post-traumatic stress disorder (PTSD) and severe mental disorders (e.g., depression, and schizophrenia spectrum disorders). The present study elucidated the latent profiles and interrelationships between emotion dysregulation and psychopathology (PTSD, dissociation, psychosis, and affective symptoms) in a trauma-exposed severe mental illness population. METHODS: We recruited a large sample of trauma-exposed outpatients with mood disorders and schizophrenia spectrum disorders in Singapore (N = 461; M age = 35.47). PTSD and dissociation were assessed with the Clinician Administered PTSD Scale for DSM-5. Psychosis and affective symptoms were assessed with the Brief Psychiatric Rating Scale-Expanded. Emotion regulation ability deficits were assessed with the Difficulties with Emotion Regulation Scale. Maladaptive emotion regulation strategies were assessed with the Ruminative Response Scale (rumination), Penn State Worry Questionnaire (worry), and Emotion Regulation Questionnaire (expressive suppression). RESULTS: Latent profile analysis identified three distinct risk profiles: severe emotion dysregulation and psychopathology (Profile 3; 19.1 %), moderate emotion dysregulation and psychopathology (Profile 2; 37.5 %), and low emotion dysregulation and psychopathology (Profile 1; 43.4 %). Network analysis identified distinct emotion dysregulation and psychopathology networks for each latent profile. Profile 3 had the highest network density and the strongest bridge connections between emotion dysregulation (poor emotional clarity) and psychopathology (PTSD symptoms of negative alterations in cognitions and mood and positive psychotic symptoms). CONCLUSIONS: We synergised both latent profile analysis and network analysis to identify subgroups of at-risk patients and elucidate interrelationships between emotion dysregulation and psychopathology within each subgroup to inform personalized assessments and interventions.