Document Type

Dissertation

Degree

Doctor of Philosophy

Major

Psychology, Clinical-Community

Date of Defense

5-13-2025

Graduate Advisor

Steven E. Bruce, Ph.D.

Committee

Rachel Winograd, Ph.D.

Kimberly Werner, Ph.D.

Robert Graziano, Ph.D.

Abstract

This study adds to current understandings of the relationship between trauma exposure and inflammation through network analysis of the sociodemographic sequelae that may influence this relationship. A reductive approach has been helpful in establishing the relationship between a pro-inflammatory state and trauma exposure, however understanding of the role of additional factors in this relationship is necessary to better understand how inflammation may serve as a transdiagnostic factor relating to mental health and biopsychosocial variables. 999 trauma-exposed individuals from the National Longitudinal Study of Adolescent to Adult Health (Add Health), 1994-2018 study at three timepoints (ages 18—26, 24—32, 33—43) were included. Data included trauma history, socioeconomic, and health behavior data collected via survey methods, and inflammation determined by high sensitivity C-reactive protein level. Network analysis (mixed graphical modeling, directed acyclic graphing) was used to determine the network structure of the trauma exposure (childhood maltreatment and adulthood traumatic event exposure)-inflammation relationship as it relates to cigarette use, socioeconomic status, substance use, depressive symptoms, age, race, and sex. Individuals reporting childhood maltreatment were more likely to experience higher than normal levels of CRP. Individuals reporting trauma history were more likely to have used substances and cigarettes within the past month. Cross-sectional network analysis suggests relationships between inflammation and biological sex and race. Childhood maltreatment evidenced relationships with biological sex, race, income, and cigarette use. Adulthood trauma exposure shared relationships with biological sex, race, substance use, and cigarette use. Depressive symptoms shared relationships with biological sex, race, income, adulthood trauma, substance use, and cigarette use. Longitudinal network comparison indicated network stability over time. Directed network analysis indicates demographic, social, and trauma exposure variables may influence inflammation, psychological symptoms, and health behaviors. The present study provides support for the importance of considering demographic, social, and health behavior variables when investigating trauma exposure and systemic inflammatory impacts. Results denote the importance of considering these factors in research, case conceptualization, and treatment. Future studies may benefit from application of a systems approach to better contextualize these processes within the individual and social environments within which they occur.

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