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

Published online by Cambridge University Press:  28 March 2022

Michael L. Crowe Open the ORCID record for Michael L. Crowe [Opens in a new window] ,
Kelly L. Harper ,
Samantha J. Moshier ,
Terence M. Keane  and
Brian P. Marx
Michael L. Crowe*
Affiliation:
National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, USA
Kelly L. Harper
Affiliation:
National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, USA
Samantha J. Moshier
Affiliation:
Department of Psychology, Emmanuel College, Boston, USA
Terence M. Keane
Affiliation:
National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, USA Department of Psychiatry, Boston University School of Medicine, Boston, USA
Brian P. Marx
Affiliation:
National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, USA Department of Psychiatry, Boston University School of Medicine, Boston, USA
*
Author for correspondence: Michael L. Crowe, E-mail: michael.l.crowe@gmail.com
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Abstract

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.

Keywords

DSM-5ICD-11network stabilityposttraumatic stress disorderveterans
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 8 , June 2023 , pp. 3525 - 3532
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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