Different approaches to measuring exposure to potentially traumatic events and their relationship with symptoms of posttraumatic stress, depression, and anxiety.

Objective

The question which types of potentially traumatic events (PTEs) are specifically associated with posttraumatic stress (PTS), and how to weigh the emotional impact of exposure to multiple PTE types, remains a subject of debate. Our key objective was to examine, in a single large sample, the extent to which exposure to a Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision Criterion A event, different ways of counting exposure to multiple PTE types, and latent classes of PTE-exposure patterns are associated with PTS.

Method

Measures of exposure to PTE types, PTS, depression, and anxiety were completed by 1,405 university students (Mage = 21.7 years; 20.1% male, 79.1% female, 0.8% other).

Results

Findings showed that (a) participants whose most impactful event was a Diagnostic and Statistical Manual of Mental Disorders congruent Criterion A event reported highest PTS levels; (b) the number of directly experienced PTE types was more strongly associated with PTS than the total number of PTE types irrespective of proximity; (c) a high and a low PTE-exposure class emerged, along with two moderate PTE-exposure classes distinguished by the presence/absence of sexual trauma, with classes evidencing moderate PTE exposure plus sexual trauma and high PTE exposure reporting highest PTS; and (d) the number of directly experienced PTEs was most strongly associated with PTS, depression, and anxiety.

Conclusion

Clinically relevant PTS remains tied to a single worst event. Our findings suggest that in predicting PTS in clinical and research settings, the number of directly experienced PTEs and patterns of exposure to PTE types may offer greater predictive value. Generalization of our study findings should be done with caution given the reliance on a student sample. (PsycInfo Database Record (c) 2026 APA, all rights reserved).