Effects of cumulative trauma load on long-term trajectories of life satisfaction and health in a population-based study.

BACKGROUND Lifetime traumatic events are known to have a detrimental long-term impact on both mental and physical health. Yet, heterogeneity in the stress response regarding well-being in adults is not well understood. This study investigates effects of cumulative trauma on latent trajectories of two indices of well-being, subjective health and life satisfaction in a large representative sample by means of latent variable modelling techniques. METHODS Data from the pairfam study wave 2-9, a longitudinal representative survey was used (N = 10,825). Individuals reported on lifetime trauma type exposure on wave 7 and indicated levels of life satisfaction and health at each wave. Different types of latent Variable Mixture Models were applied in an iterative fashion. Conditional models investigated effects of cumulative trauma load. RESULTS The best fitting model indicated three latent trajectories for life, and four for health, respectively. Trauma load significantly predicted class membership: Higher exposure was associated with non-stable trajectories for both indices but followed complex patterns of both improving and decreasing life satisfaction and health. Trauma load also explained variability within classes. CONCLUSIONS The current study expands on evidence to the long-term development of health and life satisfaction in response to traumatic events from a latent variable modelling perspective. Besides detrimental effect, it also points to functional adaptation after initial decline and increased well-being associated with trauma exposure. Thus, response to traumatic stress is marked by great heterogeneity. Future research should focus on variables beyond exposure to trauma that can further identify individuals prone to trajectories of declining well-being.