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Dynamic networks of PTSD symptoms during conflict

Talya Greene · Marc Gelkopf · Sacha Epskamp · Eiko I. Fried

105 citations0/0 files storedPsychological Medicine

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Posttraumatic Stress Disorder Research Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Mental Health Research Topics

Abstract

BACKGROUND: Conceptualizing posttraumatic stress disorder (PTSD) symptoms as a dynamic system of causal elements could provide valuable insights into the way that PTSD develops and is maintained in traumatized individuals. We present the first study to apply a multilevel network model to produce an exploratory empirical conceptualization of dynamic networks of PTSD symptoms, using data collected during a period of conflict. METHODS: Intensive longitudinal assessment data were collected during the Israel-Gaza War in July-August 2014. The final sample (n = 96) comprised a general population sample of Israeli adult civilians exposed to rocket fire. Participants completed twice-daily reports of PTSD symptoms via smartphone for 30 days. We used a multilevel vector auto-regression model to produce contemporaneous and temporal networks, and a partial correlation network model to obtain a between-subjects network. RESULTS: Multilevel network analysis found strong positive contemporaneous associations between hypervigilance and startle response, avoidance of thoughts and avoidance of reminders, and between flashbacks and emotional reactivity. The temporal network indicated the central role of startle response as a predictor of future PTSD symptomatology, together with restricted affect, blame, negative emotions, and avoidance of thoughts. There were some notable differences between the temporal and contemporaneous networks, including the presence of a number of negative associations, particularly from blame. The between-person network indicated flashbacks and emotional reactivity to be the most central symptoms. CONCLUSIONS: This study suggests various symptoms that could potentially be driving the development of PTSD. We discuss clinical implications such as identifying particular symptoms as targets for interventions.

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References

1969Investigating Causal Relations by Econometric Models and Cross-spectral Methods 2015The Posttraumatic Stress Disorder Checklist for DSM‐5 (PCL‐5): Development and Initial Psychometric Evaluation 2002Diary Methods: Capturing Life as it is Lived 2017A network theory of mental disorders 1980Attribution Theory and Research 2013Intensive Longitudinal Methods: An Introduction to Diary and Experience Sampling Research 2016Can network analysis transform psychopathology?2016Mental disorders as networks of problems: a review of recent insights

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2021Consolidation/reconsolidation therapies for the prevention and treatment of PTSD and re-experiencing: a systematic review and meta-analysis 2022Auditing the research practices and statistical analyses of the group-level temporal network approach to psychological constructs: A systematic scoping review

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