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Network Analysis of Posttraumatic Stress Disorder Symptoms in a National Sample of U.S. Adults: Implications for the Phenotype and the ICD‐11 Model of PTSD
Author(s) -
Cero Ian,
Kilpatrick Dean G.
Publication year - 2020
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.22481
Subject(s) - dsm 5 , psychology , mood , psychiatry , posttraumatic stress , clinical psychology
The phenotype for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Diseases ( DSM‐5 ) includes 20 symptoms in four clusters. In contrast, the PTSD model in the 11th revision of the International Classification of Diseases ( ICD‐11 ) includes six symptoms in three clusters. Whether those six symptoms are, in fact, the most central symptoms of the PTSD phenotype remains an open question. In a previous network analysis of DSM‐5 PTSD symptoms, Mitchell and colleagues (2017) reported limited overlap between central PTSD symptoms and those in the ICD‐11 model in a national sample of U.S. veterans. The present study sought to replicate and extend upon these findings in a large national sample of U.S. adults ( N = 2,953). Centrality statistics from both a replication sample (i.e., participants with DSM‐5 PTSD, n = 173) and an extension sample (i.e., participants who had been exposed to potentially traumatic events, n = 2,468) were moderately strongly convergent with the findings reported by Mitchell et al., r s = .54–.73. Additionally, only three of the six most central symptoms in both the replication and extension samples overlapped with the ICD‐11 model, indicating that the ICD‐11 model (a) failed to include network‐central symptoms of the PTSD phenotype and (b) included extra symptoms that were not network‐central. Several symptoms from the DSM‐5 Criterion D cluster (negative alterations in cognition and mood) that were excluded in ICD‐11 were found to be among the most central PTSD symptoms.