Joseph, Shadiq; (2025) Identifying distinct profiles of PTSD symptoms in individuals receiving routine psychological treatment and their association with demographic characteristics and treatment outcome. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Background: Post-Traumatic Stress Disorder (PTSD) presents with considerable variation in symptom type and severity, making it challenging to apply uniform treatment approaches. Traditional diagnostic methods may overlook meaningful differences between individuals. To address this, person-centred methods such as Latent Profile Analysis (LPA) can be used to identify distinct symptom profiles based on patterns of symptom endorsement. This study applies LPA to item-level data from the Impact of Event Scale–Revised (IES-R) to identify PTSD subtypes from individuals receiving routine psychological treatment. Understanding these profiles can offer more targeted insights into symptom presentation and inform treatment planning. Given known disparities in mental health outcomes among people from low socio-economic and ethnic backgrounds, examining the intersection of PTSD profiles and demographic characteristics may contribute to more personalised and equitable treatment strategies. Aim: This study aimed to identify distinct PTSD symptom profiles using item-level IES-R data and examine whether treatment outcomes differ by profile membership and demographics. Methods: Data was collected from four IAPT services in the North and Central East London IAPT Service Improvement and Research Network (NCEL IAPT SIRN). Patients were included if they met caseness on a PTSD scale (e.g., IES-R) and had attended a minimum of 2 treatment sessions. Latent Profile Analysis (LPA) was used on item-level PTSD symptom scores to identify statistically distinct profiles based on PTSD symptoms. Chi-squared and T-tests were used to examine whether PTSD profile membership was associated with ethnicity and other demographic and clinical characteristics. A logistic binary regression was then used to examine whether PTSD profile membership was associated with differential treatment outcomes when controlling for demographic indicators. Results: Two distinct PTSD profiles were revealed with the main difference attributed to symptom severity (Low intensity profile & High intensity profile). Profile membership was significantly associated with the likelihood of experiencing different treatment outcomes. Profile 2 (high intensity) had poorer treatment outcomes. Medication use and employment status was associated with profile membership, but not treatment outcomes. Other demographic characteristics was not revealed to be significantly associated with profile membership or treatment outcomes. Conclusion: The findings highlight the heterogeneity of PTSD in clinical settings and demonstrate the utility of data-driven profiling to support tailored treatment. While severity-based profiles were associated with differential treatment outcomes, the lack of demographic differences may reflect sampling limitations. The study highlights the need for more inclusive research and flexible, stratified treatment approaches to improve outcomes for individuals with complex PTSD presentations.

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