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Network analysis of PTSD and depressive symptoms in 158,139 treatment‐seeking veterans with PTSD
Author(s) -
Duek Or,
Spiller Tobias Raphael,
Pietrzak Robert H.,
Fried Eiko I.,
HarpazRotem Ilan
Publication year - 2021
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.23112
Subject(s) - anhedonia , psychology , comorbidity , clinical psychology , intrusion , psychiatry , centrality , depression (economics) , feeling , posttraumatic stress , depressive symptoms , sample (material) , anxiety , social psychology , chemistry , schizophrenia (object oriented programming) , mathematics , geochemistry , chromatography , combinatorics , economics , macroeconomics , geology
Abstract Background In recent years, a new framework for analyzing and understanding posttraumatic stress disorder (PTSD) was introduced; the network approach. Up until now, network analysis studies of PTSD were largely conducted on small to medium sample sizes ( N < 1,000), which might be a possible cause of variability in main findings. Moreover, only a limited number of network studies investigated comorbidity. Methods In this study, we utilized a large sample to conduct a network analysis of 17 symptoms of PTSD (DSM‐IV), and compared it to the result of a second network consisting of symptoms of PTSD and depression (based on Patient Health Questionnaire‐9 [PHQ‐9]). Our sample consisted of 502,036 treatment‐seeking veterans, out of which 158,139 had fully completed the assessment of symptoms of PTSD and a subsample of 32,841 with valid PCL and PHQ‐9 that was administered within 14 days or less. Results Analyses found that in the PTSD network, the most central symptoms were feeling distant or cut off from others, followed by feeling very upset when reminded of the event, and repeated disturbing memories or thoughts of the event. In the combined network, we found that concentration difficulties and anhedonia are two of the five most central symptoms. Conclusion Our findings replicate the centrality of intrusion symptoms in PTSD symptoms' network. Taking into account the large sample and high stability of the network structure, we believe our study can answer some of the criticism regarding stability of cross‐sectional network structures.