Heterogeneity and stability of patterns of post-traumatic stress symptoms and sleep quality: evidence from one year longitudinal study.

INTRODUCTION: This study aimed to explore the heterogeneity of psychological states among civilians during the COVID-19 pandemic and the patterns of change over time. The focus was on Post-Traumatic Stress Symptoms (PTSS) and sleep quality. METHODS: The PCL-5 and a simplified Pittsburgh Sleep Quality Index were utilized to measure PTSS and sleep quality. Initial data collection in February 2021 yielded 542 responses, with a follow-up 11 months later capturing 329 valid responses. Latent Profile Analysis identified psychological response heterogeneity, while Latent Transition Analysis and variance analysis explored subgroup changes. Chi-square and regression analyses examined the influence of gender on classification and transitions. RESULTS: Three stable subgroups of PTSS and sleep quality were identified: Healthy (T1 10.94%, T2 12.77%), At Risk (T1 58.97%, T2 42.55%), and PTSD (T1 30.09%, T2 44.68%). Variance analysis showed significant differences in PTSS and sleep quality among the three subgroups at T2. LTA indicated the probabilities of subgroup members remaining in their original group were 0.69, 0.84, and 0.67, respectively, with women more likely to be classified in the PTSD group and to transition to it. DISCUSSION: The study identified three distinct psychological patterns of sleep and PTSS, which were found to be stable and persistent. However, the analysis of changes revealed that individuals are more susceptible to shifting towards a moderate risk state. Female gender was identified as a risk factor for the more vulnerable psychological patterns. By providing a more nuanced classification of the comorbidity of PTSS and sleep disorders, this study lays a theoretical foundation for personalized treatment and intervention strategies.