4.7 Article

Longitudinal PTSD network structure: measuring PTSD symptom networks over 5 years

Journal

PSYCHOLOGICAL MEDICINE
Volume 53, Issue 8, Pages 3525-3532

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291722000095

Keywords

DSM-5; ICD-11; network stability; posttraumatic stress disorder; veterans

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This study used five-year data collection and analysis of PTSD symptom data in a sample of military veterans to establish a reliable PTSD symptom network. The study found that negative trauma-related emotions had strong associations with the network, while trauma-related amnesia, sleep disturbance, and self-destructive behavior had weaker associations with other symptoms. The results suggest that the network structure of PTSD is stable over time.
Background Network modeling has been applied in a range of trauma-exposed samples, yet results are limited by an over reliance on cross-sectional data. The current analyses used posttraumatic stress disorder (PTSD) symptom data collected over a 5-year period to estimate a more robust between-subject network and an associated symptom change network. Methods A PTSD symptom network is measured in a sample of military veterans across four time points (Ns = 1254, 1231, 1106, 925). The repeated measures permit isolating between-subject associations by limiting the effects of within-subject variability. The result is a highly reliable PTSD symptom network. A symptom slope network depicting covariation of symptom change over time is also estimated. Results Negative trauma-related emotions had particularly strong associations with the network. Trauma-related amnesia, sleep disturbance, and self-destructive behavior had weaker overall associations with other PTSD symptoms. Conclusions PTSD's network structure appears stable over time. There is no single 'most important' node or node cluster. The relevance of self-destructive behavior, sleep disturbance, and trauma-related amnesia to the PTSD construct may deserve additional consideration.

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