Commentary on the Special Issue on Network Analysis: Assessment, Intervention, Theory, and the Nature of Reality: Actualizing the Potential of Network Perspectives on Posttraumatic Stress Disorder

Abstract

This commentary on the Journal of Traumatic Stress special issue on network analysis explores the network perspective on posttraumatic stress disorder (PTSD), emphasizing the advances in research made in this collection of articles. The commentary is organized around the following themes related to actualizing the perspective's methodological, assessment, and intervention potential and the potential shift in the theoretical underpinnings of mental disorders that networks models imply. First, extant data using network analysis suggest that reactions to traumatic stress are more complicated than once thought but that this complexity does not mean efficient, relatively simple heuristics to aid assessment and intervention do not exist. Attention to methodological issues in symptom assessment may help move this aspect of the research forward. Second, the extant research is largely correlational and has not yet established causal linkages, although temporal associations underlying network models are being identified. Prospective and intervention studies employing network analysis are critical. Third, the network perspective of PTSD symptoms may advance research on the mechanisms of risk and resilience (e.g., neurodevelopmental, cognitive behavioral, emotional, and social models) by helping link symptoms to theoretical causal processes. A developmental framework that views the effect of traumatic stress in terms of temporal cascades of reactions with both negative and potentially positive cognitive, behavioral, social, and emotional outcomes fits the network analysis model. Fourth, network models call into question some of the fundamental assumptions underlying the conceptualization of mental disorders, leaving several ontological questions and implications currently unanswered; research examining the implications of the new assumptions is needed.

Toward a Developmental Model of Continuity and Change in PTSD Symptoms following Exposure to Traumatic and Adverse Experiences

“…The extant network research has not established the causal basis underlying network models (Weems, 2020); however, research has begun to identify interesting developmental and temporal linkages. For example, McBride et al (2020) employed network analysis to test how adult survivors of childhood sexual abuse experienced symptoms of posttraumatic stress.…”

“…Recognizing this in treatment goal setting, assessment of intervention outcomes, and diagnosis may benefit clinicians by helping to identify subtle persistence of the negative effects of exposure to TRACEs. Another avenue for future research is that symptom level analysis may aid in the development of intervention approaches targeting symptoms with a high degree of stability overtime or those likely to emerge even if not present currently (see e.g., Weems, 2020). For example, those symptoms that are likely to remain stable or remain stable or emerge later in certain age groups may be a useful focus for intervention.…”

Assessing perceptions of resilience: The understanding from network analysis

“…The idea of resilience has become prevalent in international development (1) due to mounting global risks (2)(3)(4). The most typical study of resilience is the traumatic resilience research (5)(6)(7). Recently, researchers have realized that shifting from the focus on the traditional methods of psychological disorder treatment, such as posttraumatic stress disorder, to the maintenance of stress-related mental health is a promising strategy, which helps to narrow the prevention gap (8)(9)(10)(11).…”

Symptom networks of COVID-19-related versus other potentially traumatic events in a global sample

“…Network analysis has become especially prominent in the field of traumatic stress and has been used in numerous studies to map the symptom structure and assess cross-cluster connections of PTSD, as well as compare networks tied to different PTEs ( Armour et al, 2017 , Weems, 2020 ). Synthesized findings have noted inconsistency of both the centrality of symptoms and symptom associations and suggest that this may support an idiographic approach to the network structure of PTSD based on particular populations ( Birkeland et al, 2020 , Isvoranu et al, 2020 ).…”