High Trauma Exposure Research Articles

Psychological predictors of posttraumatic stress and depression in firefighters: A 2-year longitudinal study

Background and objectivesDue to high trauma exposure in their job, first responders have an increased chance to develop posttraumatic stress disorder (PTSD) and depression. A challenge in the psychotrauma field is to develop effective preventive strategies for high-risk professionals. The aim of this study was to test which malleable psychological factors (resilience, social support at work, experiential avoidance, repetitive negative thinking (RNT), meaning in life, sense of coherence) predict the development of PTSD and depression symptoms in firefighters. MethodFirefighters (n = 393) were tested at baseline (PTSD, depression and risk factors) and filled out questionnaires in the following 2 years (PTSD and depression). Regression analyses were run testing which set of risk factors best predicted PTSD or depression symptoms at follow-up, when controlling for baseline symptomatology. ResultsLower social support at work and higher experiential avoidance predicted PTSD symptom development, and lower meaning in life and higher RNT predicted depression symptom development. ConclusionsDecreasing experiential avoidance and RNT and promoting social support at work and meaning in life seem promising targets for primary prevention interventions in first responders. Future studies should test whether targeting these risk factors would indeed decrease the development of post-trauma psychopathology in high-risk professionals.

Military sexual trauma, childhood trauma, and combat trauma: Associations with longitudinal posttraumatic growth among U.S. Veterans.

Military sexual trauma (MST), childhood trauma, and combat trauma are prevalent among U.S. military personnel. Cumulative trauma exposure may hinder posttraumatic growth, a positive psychological change following traumatic events, while social support can facilitate this growth. Understanding the influence of these traumas and social support on longitudinal posttraumatic growth is crucial. We assessed 1,230 veterans at 6, 9, 12, 18, and 24 months postinitial survey. Latent class analysis identified trauma experience classes, and latent growth models examined posttraumatic growth trajectories, incorporating social support as a time-varying covariate. The latent class analysis revealed four classes: high trauma exposure, moderate childhood trauma-moderate combat trauma, high MST-moderate combat trauma, and combat trauma only. Veterans in the combat-only class reported significant posttraumatic growth. The moderate childhood trauma-moderate combat class exhibited consistently low growth. Veterans in the high MST-moderate combat class showed slightly higher initial growth but no significant change over time. The high trauma exposure class experienced a significant decline in growth. Social support significantly predicted posttraumatic growth, with varying impacts across trauma classes. Interventions could be vital for survivors of MST, childhood trauma, or compounded traumas to enhance posttraumatic growth among military veterans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Patterns and transitions of posttraumatic stress symptoms and posttraumatic growth in trauma-exposed youth: A latent transition analysis.

The present study examined the transition patterns in latent classes of Post-traumatic stress disorder (PTSD) and post-traumatic growth among a sample of youth 4-13months after an explosion accident in China. Latent profile analyses identified consistent three classes (Resilient, Growing, and High-Symptom) at both waves. Latent transition analysis found most Resilient individuals remained stable while most Growing and High-symptom individuals transferred. Logistic regression predicting transition pathways suggests younger individuals, males, and those who lack social support are prone to experience reduced post-traumatic growth, whereas individuals with higher trauma exposure are prone to develop PTSD. Our study provides empirical evidence supporting qualitative transitions in PTSD and post-traumatic growth levels from a person-centred perspective. This adds to the current knowledge on the heterogeneity of post-traumatic responses of human beings and offers valuable guidance for post-traumatic interventions among youths.

Identifying psychological risk and resilience in high-risk military personnel

IntroductionCombat exposure has been associated with the emergence of post-traumatic stress disorder (PTSD) symptoms in military personnel; however, not all veterans are negatively impacted by their operational experience. In many...

Unaccompanied migrant children in the United States: Implementation and effectiveness of trauma-focused cognitive behavioral therapy.

The number of unaccompanied children (UC) arriving in the United States (U.S.) from other countries has increased significantly over the past decade. UC report high trauma exposure and greater posttraumatic stress symptoms compared with youth who immigrate with caregivers. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has demonstrated preliminary effectiveness with UC. However, few studies have treated U.S.-based samples of UC, who emigrate primarily from Central America. One hundred thirty-eight UC were referred for treatment and 129 completed a pretreatment assessment including the Child and Adolescent Trauma Screen (CATS) and the Strengths and Difficulties Questionnaire (SDQ). Most UC were from Central America (n = 109; 79.0%) and resided in government facilities (n = 76; 55.1%). One hundred twenty-two youth began TF-CBT, had an average of 9.71 sessions (SD = 9.3, range: 1-48), and 41.8% (n = 51) completed treatment. One hundred four youth completed a brief, six-item progress monitoring measure of trauma symptoms, for which 84 had at least two observations during treatment. UC endorsed 3.80 traumatic events on average (SD = 2.38). High rates of violence, physical and sexual abuse, and serious injury were reported. There were significant improvements on most self-report rating scales (p < .05); within-subjects Cohen's d's ranged from .07 to 1.03 for pre- to posttreatment assessments and was d = .44 for the progress monitoring measure. Therapists reported on TF-CBT modifications for UC, including discussing mental health beliefs, navigating roles and relationships, tailoring treatment examples, exploring coping strategies, and addressing immigration factors. Preliminary findings support the utility of TF-CBT with UC. Implications for implementation and cultural modifications are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

THE EFFECT OF LIFESPAN TRAUMA EXPOSURE ON PATHOLOGICAL PERSONALITY TRAITS

Abstract Introduction The Alternative Model of Personality Disorders (AMPD) is a dimensional model of personality disorder pathology focusing on pathological personality traits, with five trait domains. Limited knowledge exists about relationships between cumulative exposure to traumatic events and the AMPD, a gap particularly relevant for older adults who have had a lifetime of potential exposure. Method: Older adults (n = 200) completed the Trauma Health Questionnaire (THQ) and Personality Inventory for DSM-5 (PID-5). Results Multivariate analysis of covariance (MANCOVA) revealed significant differences in the five PID-5 domains across four levels of cumulative trauma exposure (Pillai’s Trace =.14, F(5, 519) =1.73, p =.04, ηp2=.05). Years since first traumatic event was not significant as a covariate (Pillai’s Trace =.02, F(4, 173) =0.80, p =.55, ηp2=.02). Significant group differences were found in the PID-5’s Psychoticism (F(3, 175) = 5.71, p &amp;lt; .001, ηp2 = .09) and Detachment (F(3, 175) = 2.91, p = .03, ηp2 = .05). According to Bonferroni post-hoc tests, the high trauma exposure group was significantly higher in Psychoticism than low trauma exposure, low to medium trauma exposure, and medium to high trauma exposure groups. For Detachment, the high trauma exposure group was significantly higher than the low trauma exposure and low to medium exposure groups. Discussion Findings suggest that cumulative trauma exposure is associated with specific pathological personality traits in older adults. High levels of trauma exposure may be particularly related to eccentric and detached traits that persist in later life, reflecting the need for clinical assessment in both domains.

Does Where You Work and What You Do Matter? Testing the Role of Organizational Context and Job Type for Future Study of Occupation-Based Secondary Trauma Intervention Development.

Organizational context (e.g., criminal justice, community-based, and healthcare) and job type (e.g., police, social workers, and healthcare providers) may impact the extent of occupation-based secondary trauma (OBST). Survey data collected from a multiphase community-based participatory research project were analyzed from a variety of professionals, who were likely to "encounter the consequences of traumatic events as part of their professional responsibilities" (n = 391, women = 55%, White = 92%). Results document high trauma exposure (adverse childhood experiences [ACEs] and workplace) and OBST-related outcomes (Maslach Burnout Inventory, Secondary Traumatic Stress Scale, post-traumatic stress disorder symptom checklist for DSM-5) for the entire sample with important differences across organizational context and job type. Using multivariate regression, the strongest determinants of suffering, however, were not related to a provider's specific profession but to their number of years on the job and their ACEs (e.g., adjusted R2 = 0.23, b = 2.01, p < .001). Likewise, the most protective factors were not profession specific but rather the provider's age and perceived effectiveness of OBST-related training (e.g., b = 2.26, p < .001). These findings inform intervention development and have implications for rural and other often under-resourced areas, where the same OBST-related intervention could potentially serve many different types of providers and organizations.

Intergenerational transmission of mental health risk in refugee families: The role of maternal psychopathology and emotional availability.

To prevent an intergenerational cycle of malfunction, it is crucial to understand how mothers' exposure to traumatic war experiences contributes to their children's vulnerability to mental health problems. This study examined the role of maternal psychopathology and mother-child emotional availability (EA) in the association between mothers' trauma exposure and children's mental health problems in a sample of 222 Burundian mother-child dyads living in refugee camps in Tanzania. Maternal and child EA were assessed through recorded observations of mother-child interactions. In structured clinical interviews, mothers reported on their lifetime exposure to traumatic events and their psychopathology and both mothers and fathers reported on children's emotional and behavioral problems. Structural equation modeling showed that mothers' higher trauma exposure was indirectly associated with higher levels of children's mental health problems through higher levels of maternal psychopathology. Mothers' higher trauma exposure was also directly associated with lower maternal EA in mother-child interactions, which was in turn related to higher levels of children's mental health problems. The findings suggest that trauma exposure independently affects mothers' mental health and their EA, which can contribute to children's mental health problems. Interventions aiming to reduce mothers' psychopathology and strengthen their EA may be beneficial for children's well-being.

Strengths and Resilience Among Central American Parents Seeking Asylum in the United States

This study examined the experiences of immigrant parents seeking asylum in the United States after recently fleeing the Northern Triangle region of Central America, attending both to the traumatic events and the strengths that mitigate this experience. The study employs a convergent parallel mixed-methods design to describe the experiences of 51 parents after being processed by U.S. immigration officials for seeking asylum. Quantitative analyses measured trauma exposure and psychological distress and posttraumatic stress symptoms, as well as religiosity, dispositional optimism, and perceived quality of life. Qualitative analyses examined migratory experiences more deeply. Quantitative findings suggest that participants displayed high levels of resilience as evidenced by the low endorsement of mental health symptoms associated with trauma despite high violence and trauma exposure. Qualitative analyses revealed two themes underscoring strengths that mitigated the compounded trauma experienced by participants, including: (a) protective factors, and (b) plans for the future. In addition, several subthemes emerged within each of these broader themes. Qualitative findings highlight that asylum seekers come to the United States for the sake of their families, especially their children. Participants shared their desire to ensure the safety of their family and children and their hope of being better able to take care of them. These desires and hopes common among participants in our study not only motivated them to leave their home countries but also helped them to press forward in their journeys. Study results show that religiosity, hope, and optimism also played important roles in sustaining these immigrant parents during their journeys.

Genetic liability to suicidal thoughts and behaviors and risk of suicide attempt in US military veterans: moderating effects of cumulative trauma burden.

Little is known about environmental factors that may influence associations between genetic liability to suicidality and suicidal behavior. This study examined whether a suicidality polygenic risk score (PRS) derived from a large genome-wide association study (N = 122,935) was associated with suicide attempts in a population-based sample of European-American US military veterans (N = 1664; 92.5% male), and whether cumulative lifetime trauma exposure moderated this association. Eighty-five veterans (weighted 6.3%) reported a history of suicide attempt. After adjusting for sociodemographic and psychiatric characteristics, suicidality PRS was associated with lifetime suicide attempt (odds ratio 2.65; 95% CI 1.37-5.11). A significant suicidality PRS-by-trauma exposure interaction emerged, such that veterans with higher levels of suicidality PRS and greater trauma burden had the highest probability of lifetime suicide attempt (16.6%), whereas the probability of attempts was substantially lower among those with high suicidality PRS and low trauma exposure (1.4%). The PRS-by-trauma interaction effect was enriched for genes implicated in cellular and developmental processes, and nervous system development, with variants annotated to the DAB2 and SPNS2 genes, which are implicated in inflammatory processes. Drug repurposing analyses revealed upregulation of suicide gene-sets in the context of medrysone, a drug targeting chronic inflammation, and clofibrate, a triacylglyceride level lowering agent. Results suggest that genetic liability to suicidality is associated with increased risk of suicide attempt among veterans, particularly in the presence of high levels of cumulative trauma exposure. Additional research is warranted to investigate whether incorporation of genomic information may improve suicide prediction models.

Central and Peripheral Immune Dysregulation in Posttraumatic Stress Disorder: Convergent Multi-Omics Evidence.

Posttraumatic stress disorder (PTSD) is a chronic and multifactorial disorder with a prevalence ranging between 6–10% in the general population and ~35% in individuals with high lifetime trauma exposure. Growing evidence indicates that the immune system may contribute to the etiology of PTSD, suggesting the inflammatory dysregulation as a hallmark feature of PTSD. However, the potential interplay between the central and peripheral immune system, as well as the biological mechanisms underlying this dysregulation remain poorly understood. The activation of the HPA axis after trauma exposure and the subsequent activation of the inflammatory system mediated by glucocorticoids is the most common mechanism that orchestrates an exacerbated immunological response in PTSD. Recent high-throughput analyses in peripheral and brain tissue from both humans with and animal models of PTSD have found that changes in gene regulation via epigenetic alterations may participate in the impaired inflammatory signaling in PTSD. The goal of this review is to assess the role of the inflammatory system in PTSD across tissue and species, with a particular focus on the genomics, transcriptomics, epigenomics, and proteomics domains. We conducted an integrative multi-omics approach identifying TNF (Tumor Necrosis Factor) signaling, interleukins, chemokines, Toll-like receptors and glucocorticoids among the common dysregulated pathways in both central and peripheral immune systems in PTSD and propose potential novel drug targets for PTSD treatment.

War-related trauma linked to increased sustained attention to threat in children.

Experiences of war and displacement can have profound effects on children's affective development and mental health, although the mechanism(s) underlying these effects remain unknown. This study investigated the link between early adversity and attention to affective stimuli using a free‐viewing eye‐tracking paradigm with Syrian refugee (n = 31, M age = 9.55, 12 female) and Jordanian non‐refugee (n = 55, M age = 9.98, 30 female) children living in Jordan (March 2020). Questionnaires assessed PTSD, anxiety/depression, insecurity, distress, and trauma. Refugee children showed greater initial avoidance of angry and happy faces compared to non‐refugee children, and higher trauma exposure was linked to increased sustained attention to angry stimuli. These findings suggest that war‐related trauma may have differential effects on the early and later stages of affective processing in refugee children.

Resilience, Growth, and Posttraumatic Symptoms among Social Workers Who Are “Doubly Exposed”

Abstract The current study examined posttraumatic stress (PTS), resilience, and posttraumatic growth (PTG) among social workers (SWs) in Israel exposed to trauma both directly and indirectly through their work. Two groups of SWs were examined: SWs with high exposure to rocket attacks (n = 50) and SWs with low exposure to rocket attacks (n = 52). Measures included objective, subjective, and professional exposure; PTS; vicarious traumatization (VT); resilience; and PTG. Differences between the two groups were found regarding objective, subjective, and professional exposure, as well as PTS, VT, and PTG. No differences were found regarding resilience. PTS and PTG were positively associated. An interaction between group and resilience in predicting PTS and PTG was found. In the highly exposed group, resilience was negatively associated with PTS and positively with PTG, whereas for the low-exposed group resilience was not associated with PTS and was negatively associated with PTG. The discussion focuses on the need to understand the role of resilience and PTG in the psychological reaction of SWs to direct as well as indirect trauma; it also weighs the possibility that PTG serves as a salutogenic variable under high-trauma exposure but as an illusionary means of self-enhancement under low-level exposure.

Trauma, Sleep and Mental Health Problems in Low-Income Young Adults.

Low-income young adults are more likely to have exposure to trauma, which increases risk for mental health problems. Although adequate sleep promotes good health, people with histories of trauma are more likely to have sleep problems. The current study explored whether poor sleep mediated the relationship between trauma exposure and mental health. A sample of 143 low-income 18–24-year-old young adults completed depression, anxiety, and trauma exposure measures and wore sleep monitors for four nights. Structural equation modeling (SEM) was used to examine both direct and indirect effects of variables. Results showed that higher trauma exposure was associated with depression and anxiety. Mean sleep hours per night was fewer than six, far below recommended guidelines for optimal health and functioning. Fewer sleep hours partially mediated the relationship between both trauma exposure and depression and anxiety, and the direct effect from trauma remained significant after adjusting for the partial mediation from sleep.

The Moderating Effect of Alcohol Use Disorder on Intimate Partner Violence Intervention Outcomes in Veterans

BackgroundVeterans report relatively high rates of intimate partner violence (IPV) due to high trauma exposure. Alcohol use disorder (AUD), which is more prevalent among veterans, is a risk factor for IPV use and recidivism following IPV intervention. Using data from a prior randomized control trial of a trauma-informed IPV intervention, we examined the moderating effect of AUD on treatment outcomes among veterans.MethodsParticipants were 61 male veterans (M age = 37.18, SD = 13.23; 82% White; 18% met criteria for AUD) who participated in the Strength at Home (SAH) IPV intervention. Generalized mixed modelling was used to examine the effects of AUD and treatment attendance on posttreatment reductions in IPV.ResultsA significant three-way interaction between time, AUD, and session attendance was observed with respect to reductions in psychological IPV. Specifically, psychological IPV decreased significantly over time, but to a lesser extent among individuals with AUD, regardless of treatment attendance.DiscussionResults indicate that participants with AUD receive less benefit from treatment with regard to coercive and controlling abusive behaviors. Findings speak to the need for adapting IPV intervention in order to address problematic alcohol use and related externalizing psychopathology.

Moral injury in civilians: associations with trauma exposure, PTSD, and suicide behavior

ABSTRACT Background: Moral injury (MI) describes emotional, spiritual, and social suffering that can arise following psychological trauma. Prior research in military populations indicates the relevance of MI to adverse psychological outcomes, such as post-traumatic stress disorder (PTSD) and suicidal behaviours, and shows evidence for MI as a unique construct. Minimal studies of MI have been implemented in civilians, usually restricted to small samples with a specific set of traumatic experiences, despite the conceptual relevance of MI to non-military trauma reactions more broadly (e.g. feelings of betrayal towards a perpetrator of sexual abuse). Objective: To address this problem, we assessed MI in trauma-exposed civilians to examine ways in which this construct was related to and distinct from trauma and traumatic stress-related problems, including PTSD and depression. Method: We adapted an existing MI scale, Moral Injury Events Scale (MIES) and administered this measure to 81 men and women along with measures of trauma exposure, PTSD and depression, and also asked participants about past suicide attempts. Results: We observed that both greater exposure and distress related to potentially morally injurious events were associated with higher trauma exposure, particularly childhood maltreatment, as well as post-traumatic and depressive psychopathology. However, even after accounting for current PTSD and depression symptoms, MI exposure (F = 6.05, p = .017) was significantly higher among participants who had previously attempted suicide. Conclusions: These pilot data reveal the ways in which MI is associated with trauma exposure, PTSD and depression and highlight the salience of MI in civilians. Similarly, these data demonstrate the unique relevance of MI to suicide behaviours, independent of post-traumatic psychopathology, indicating that this construct may be an understudied contributor to suicide risk in civilians.

Indirect effects of PTSD and complex PTSD in the relationship of polyvictimization with intimate partner violence victimization and perpetration among men in mandated treatment

ABSTRACT Background: Polyvictimization is associated with posttraumatic stress disorder (PTSD), severe impairment, and re-victimization, including due to intimate partner violence (IPV), but polyvictmization’s role in the perpetration of IPV is less clear. Objective: To examine the indirect effect of PTSD and complex PTSD in the relationship between polyvictimization and IPV perpetration. Method: Polyvictims were identified by cluster analysis of self-reported lifetime victimization history data in a random national sample (N = 234) of men at 66 clinical treatment centers for domestic violence perpetrators in Israel. Results: Four sub-groups were identified: low exposure to abuse and physical neglect (C1, N = 105), and three polyvictim sub-groups characterized by multiple forms of past exposure to neglect and verbal abuse (C2, N = 38), to verbal and physical abuse without neglect (C3, N = 46), or to neglect and both verbal and physical abuse (C4, N = 28). Participants also were characterized as having low exposure to traumatic events across the lifespan (cluster L5, N=156), or high exposure to traumatic events across the lifespan (cluster L6, N=78). Complex PTSD symptoms had an indirect effect in the relationship between membership in the C3 and C4 polyvictimization clusters (β=.45, p<.05, β=.60, p<.05; respectively) and severity of psychological IPV victimization, as well as between C3 polyvictimization cluster membership and severity of psychological IPV perpetration (β=.32, p<.05). In contrast, PTSD symptoms had no indirect effect in any relationship between cluster membership and IPV outcomes. High lifetime trauma exposure also was directly associated with sexual IPV victimization. Conclusions: Complex PTSD may be a mechanism linking polyvictimization to the severity of both IPV victimization and perpetration. Clinical implications are discussed.

Abstract 12702: Association of Posttraumatic Stress Disorder With Incident Ischemic Heart Disease in Women Veterans

Introduction: Posttraumatic stress disorder (PTSD) is associated with greater risk of ischemic heart disease (IHD). Women veterans represent a growing, yet understudied, population with high trauma exposure and a unique cardiovascular risk profile, but research on the PTSD-IHD relation in this group is lacking. Hypothesis: PTSD is associated with incident IHD in women veterans. Methods: Veterans Administration (VA) electronic medical records (EMR) was used to identify women veterans who received care from any VA from 1/1/2000-12/31/2017. Exclusion criteria included: no VA follow-up(s) after index visit; IHD diagnosis at or before index visit; IHD diagnosis within 90 days of index visit. Propensity score matching on age at index visit, year of index visit, number of visits before index visit, and presence of traditional and female-specific cardiovascular risk factors and mental and physical health conditions was conducted in a 1:2 ratio to identify 129,510 women veterans with PTSD and 259,020 women veterans without PTSD. PTSD was defined by International Classification of Disease (ICD)-9/ICD-10 diagnosis codes and inpatient or outpatient encounters. Incident IHD was defined as new-onset coronary artery disease, angina, or myocardial infarction diagnoses based on ICD-9/ICD-10 diagnosis codes and inpatient or outpatient encounters. Results: The analytic sample was relatively young (mean age=40.3 ( SD =12.5)). Median length of follow-up was 1,921 days (interquartile range=884-3,547 days). In a propensity score-adjusted Cox proportional hazards model, PTSD was significantly associated with greater risk of developing IHD (HR=1.15, 95% CI 1.10-1.19; P &lt;.001). Secondary stratified analyses indicated that women veterans with PTSD who were of younger age (particularly those aged &lt;40 years), Black race, and Hispanic/Latino ethnicity, plus those exposed to military sexual trauma, exhibited some of the greatest elevations in incident IHD risk. Conclusions: Findings demonstrate that PTSD is an independent predictor of incident IHD in women veterans, especially in younger women and racial and ethnic minorities. Results may have implications for IHD risk assessment in these vulnerable populations.

Spiritual Decline as a Predictor of Posttraumatic Stress

Many college students in the United States arrive on campus with exposure to both traumatic events and typical negative life events, as well as varying levels of emotional wellness. One way that students may seek out help is through spiritually supportive wellness programming. The current study examines the prevalence of and relationship between traumatic life events, typical negative life events, and spiritual growth and decline as predictors of posttraumatic stress in a sample of undergraduates (N = 88) seeking spiritually supportive wellness. Traumatic and typical negative life events and spiritual decline were predictive of posttraumatic stress. Furthermore, a moderation effect was found such that while participants with high trauma exposure and high spiritual decline reported the highest posttraumatic stress, those with high trauma exposure and low spiritual decline reported lower posttraumatic stress, similar to those with low trauma exposure. These results have implications for the role of spiritual decline in the etiology of PTSD (Posttraumatic Stress Disorder) within emerging adult populations who identify as spiritual that warrant further study.

The Effects of Polyvictimization on Mental and Physical Health Outcomes in an LGBTQ Sample.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals are at elevated risk for violent victimization and often experience increased health disparities compared to their non-LGBTQ counterparts. The present study examined associations between polyvictimization and mental and physical health in an LGBTQ sample. Participants included 385 LGBTQ individuals involved in a larger health-needs assessment of LGBTQ individuals living in the southeastern United States. The sample primarily identified as gay/lesbian (63.4%), cisgender (78.7%), and White (66.5%), and the mean participant age was 34.82 years (SD = 13.45). A latent class analysis (LCA) was conducted on seven items assessing different types of violence exposure. The LCA identified a three-class model, with classes characterized by low trauma exposure (71.4%), nondiscriminatory violence (15.1%), and high trauma exposure (13.5%). Differences in demographic characteristics, perceptions of mental and physical health, and diagnoses of specific health conditions were assessed across classes. The high-trauma class reported poorer perceived physical and mental health compared to the other two classes, with mean differences in past-month poor health days ranging from 11.38 to 17.37. There were no differences between the classes regarding specific physical health conditions; however, the high-trauma and nondiscriminatory violence classes had significantly higher rates of anxiety, depression, drug abuse, and suicidality than the low-trauma class, ORs = 2.39-23.83. The present findings suggest that polyvictimization is an important risk factor for poor health among LGBTQ individuals. These results have implications for addressing health disparities among the broader LGBTQ community.