Posttraumatic Stress Symptoms, Buffering Resources, and Avoidant Coping Strategies in Patients With Cirrhosis: A Latent Class Analysis
Jintao Cheng, Huiqiong Gui, Suyun Guo, Yihua Yang, Yun RanABSTRACT
Objective
To identify latent classes of posttraumatic stress symptoms (PTSS), buffering resources (social support and sense of control), and avoidant coping strategies among patients with cirrhosis, and to examine demographic and clinical factors associated with class membership.
Methods
From October 2024 to May 2025, patients with cirrhosis were recruited by convenience sampling from a tertiary hospital in Shenzhen, Guangdong Province. Participants completed the Perceived Social Support Scale (PSSS), PTSD Checklist‐Civilian Version (PCL‐C), Spheres of Control Scale (SCS), and Self‐Report Coping Scale (SRCS). Latent class analysis was used to identify subgroups, followed by multinomial logistic regression to examine associated factors.
Results
A total of 316 patients were included. Mean scores were 60.78 ± 16.00 for social support, 30.67 ± 11.99 for PTSS, 48.42 ± 12.07 for sense of control, and 29.53 ± 9.26 for avoidant coping. Three latent classes were identified: the Buffering Type—Low Avoidance/Symptoms Group (64.2%), the Buffering Deficiency— Symptoms/Avoidance Dilemma Group (7.5%), and the Avoidant Coping—Symptoms Dilemma Group (28.2%). In the pooled adjusted model, decompensated cirrhosis differentiated Class 2 from Class 1, while unmarried status, monthly income < 5000 RMB, unemployment, and decompensated cirrhosis differentiated Class 3 from Class 1. Although gender differed across classes in univariate analysis, the adjusted C1‐versus‐C3 gender effect was not statistically significant (OR = 0.780, 95% CI 0.365–1.667, p = 0.523). Because Class 2 contained only 24 participants, estimates involving this class should be interpreted cautiously.
Conclusion
Patients with cirrhosis showed heterogeneous profiles of PTSS, buffering resources, and avoidant coping. Disease stage and selected social and economic characteristics were associated with class membership. The small Class 2 should be considered a provisional profile requiring replication before firm class‐specific clinical conclusions are drawn.