Quality of Life and Trauma Among a Low-Income Urban-Dwelling Latinx Population: Understanding Correlates of Distress to Support Recovery and Address Disparities

Background and Purpose: The public-health consequence of trauma exposure is vast and includes depression, posttraumatic stress disorder (PTSD), substance abuse, and increased functional impairment, such as unemployment, social and family strains, and increased physical health problems. The impact of these are highest among racial/ethnic minorities, especially Latinx populations who experience trauma at higher rates and are less likely to seek treatment than non-Hispanic Whites, resulting in more psychosocial stressors and increased rates of PTSD.  While there are evidence-based, clinically effective trauma treatments available, economic and systemic factors serve as barriers for Latinxs seeking care.  Factors such as limited social support and complications accessing and adhering to services makes the care experience less effective in managing current and future episodes of trauma and deterring treatment decisions. 

Given these disparities in mental-health care for Latinxs experiencing complex trauma, identifying correlates with variations in symptoms associated with PTSD severity is important to successfully approach treatment and provide support in managing the multi-layered needs that emerge in the recovery process. The study aim is to examine correlates with expressed distress associated with PTSD to inform how to best integrate treatment needs to support care for this population. 

Methods: A secondary data analysis of patient level data collected from participants prior to receiving services from a community-based care setting was done to examine correlates with reported PTSD symptoms among trauma-exposed Latinx adults (n=336; 18-years and older).  Direct effects of quality of life (WHO-QOL–Health, Psychological, Social Support, and Environmental domains) on reported trauma symptoms as measured by the PTSD Checklist for DSM-5 (PCL-5) using hierarchical linear regression were examined. 

The study sample met cut off criteria for PTSD (PCL-5  ≥ 33; M = 45.9, S.D. = 18.7) and reported experiencing on average 4.87 (S.D. = 3.09) types of traumatic events in their lifetime. By majority the sample identified as female (83%), Mexican (76%), reported as born outside of the United States (61.3%), and approximately half the sample spoke Spanish only (49.1%).  A review of the WHO-QOL measure indicated impaired functioning across each domain.

Results: Findings revealed quality of life in the domains of health (t = -3.57, p =.000, β = -.311), psychological well-being (t = -1.97, p = .050, β = -.159), and social support (t = -2.52, p =.013, β = -.182) were negatively associated with reported PTSD symptoms. However, quality life relating to environmental factors was positively associated with expressed PTSD symptoms (t= 2.75, p=.007, β = .211).  Though no demographic characteristics were significant, the number of reported types of traumas experienced was positively associated with reported PTSD symptoms (t= 5.092, p=.000, β= .381).

Conclusion and Implications: Results suggest the need to emphasize resources in the treatment experience that help manage the impact of PTSD on multi-faceted daily life needs to support well-being. Promoting connections to alleviate stress around health, social support, and community can remove barriers to care and enhance perceived value of mental health treatment supporting engagement, and ultimately maximize the potential for positive outcomes.