The Association of Posttraumatic Stress Disorder, Complex Posttraumatic Stress Disorder and Depression: A Network Approach

BackgroundComplex posttraumatic stress disorder (CPTSD) is a newly recognized condition in the ICD-11, characterized by the core symptoms of PTSD alongside disturbances in self-organization (DSO). Network analysis provides a novel approach to understanding the complex relationships between symptoms. While many studies have identified the comorbidity between PTSD/CPTSD and depression, few have focused on CPTSD using network analysis. This study aims to investigate the bridge symptoms between PTSD, DSO and depression.MethodA sample of 385 US participants who reported at least one lifetime trauma completed the ICD-11 International Trauma Questionnaire (ITQ) and the Patient Health Questionnaire-9 (PHQ-9).ResultsThe obtained network models were stable. The most central symptoms were 'Feeling distant or cut off from people', 'Feeling down, depressed, or hopeless' and 'Feeling like a failure'. The key bridge symptoms in the network were 'Negative self-concept', 'Feeling like a failure', 'When I am upset, it takes me a long time to calm down' and 'Finding it hard to stay emotionally close to people'.ConclusionsThe results indicate that certain symptoms are considerably more influential within the network. Affective, identity and interpersonal DSO symptoms may play a key role in linking PTSD and depression. These symptoms may be important targets for interventions.