Evaluating the stability of DSM-5 PTSD symptom network structure in a national sample of U.S. military veterans

Stockert, Sophia H.H. von; Fried, Eiko I.; Armour, Chérie; Pietrzak, Robert H.

doi:10.1016/j.jad.2017.12.043

Cited by 47 publications

(55 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Extensive research implementing network models in PTSD among trauma-exposed adult populations, including several in veterans, has been conducted over the last several years, aiming to elucidate the symptom structure of PTSD (McNally et al, 2015;Knefel et al, 2016;Armour et al, 2017;Birkeland and Heir, 2017;Bryant et al, 2017;Haag et al, 2017;Mitchell et al, 2017;Spiller et al, 2017;Afzali et al, 2017aAfzali et al, , 2017bMcNally et al, 2017a;Benfer et al, 2018;Fried et al, 2018;Greene et al, 2018;Moshier et al, 2018;Papini et al, 2018;Phillips et al, 2018;Ross et al, 2018;Sullivan et al, 2018;Vanzhula et al, 2018;von Stockert et al, 2018;Price et al, 2019). While some similarities in findings across studies exist, important disparities emerge (Birkeland andHeir, 2017, Phillips et al, 2018).…”

mentioning

confidence: 99%

“…For adequate power, sample size should be considerably larger than the number of parameters estimated in analyses, which given the number of variables in PTSD-related networks, tends to be relatively high (Spiller et al, 2017;Afzali et al, 2017aAfzali et al, , 2017bMcNally et al, 2017a, Fried et al, 2018) 1 † . To date, six studies used large samples of about 1000 participants (Bryant et al, 2017;Fried et al, 2018;Phillips et al, 2018;Sullivan et al, 2018;von Stockert et al, 2018;Price et al, 2019). Still, four assessed trauma-exposed participants with low-to-none rates of probable PTSD (Bryant et al, 2017;Sullivan et al, 2018;von Stockert et al, 2018;Price et al, 2019), the fifth pooled data from four datasets differing on country of origin, symptoms assessed, and assessment language and tools (Fried et al, 2018), and, as stated previously, all six studies assessed PTSD symptoms based on self-report measures only.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Symptom structure of PTSD and co-morbid depressive symptoms – a network analysis of combat veteran patients

et al. 2019

View full text Add to dashboard Cite

Background Despite extensive research, symptom structure of posttraumatic stress disorder (PTSD) is highly debated. The network approach to psychopathology offers a novel method for understanding and conceptualizing PTSD. However, extant studies have mainly used small samples and self-report measures among sub-clinical populations, while also overlooking co-morbid depressive symptoms. Methods PTSD symptom network topology was estimated in a sample of 1489 treatment-seeking veteran patients based on a clinician-rated PTSD measure. Next, clinician-rated depressive symptoms were incorporated into the network to assess their influence on PTSD network structure. The PTSD-symptom network was then contrasted with the network of 306 trauma-exposed (TE) treatment-seeking patients not meeting full criteria for PTSD to assess corresponding network differences. Finally, a directed acyclic graph (DAG) was computed to estimate potential directionality among symptoms, including depressive symptoms and daily functioning. Results The PTSD symptom network evidenced robust reliability. Flashbacks and getting emotionally upset by trauma reminders emerged as the most central nodes in the PTSD network, regardless of the inclusion of depressive symptoms. Distinct clustering emerged for PTSD and depressive symptoms within the comorbidity network. DAG analysis suggested a key triggering role for re-experiencing symptoms. Network topology in the PTSD sample was significantly distinct from that of the TE sample. Conclusions Flashbacks and psychological reactions to trauma reminders, along with their strong connections to other re-experiencing symptoms, have a pivotal role in the clinical presentation of combat-related PTSD among veterans. Depressive and posttraumatic symptoms constitute two separate diagnostic entities, but with meaningful between-disorder connections, suggesting two mutually-influential systems.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Symptom structure of PTSD and co-morbid depressive symptoms – a network analysis of combat veteran patients

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Building on the findings reported by Bryant et al. (), von Stockert, Fried, Armour, and Pietrzak () found the high centrality of negative emotions—compared to other PTSD symptoms—to be stable over time in the chronic posttrauma phase (an average of 26 years had elapsed since trauma exposure in their sample). Combined, these findings suggest that there may be differences in trauma responses between the early versus long‐term periods after trauma exposure.…”

mentioning

confidence: 64%

“…() and von Stockert et al. () suggest that negative self‐conscious cognitions and emotions would be less salient in the short‐term posttrauma phase in contrast to the long‐term posttrauma phase. As these cognitions and emotions could influence maladaptive behaviors, the present study continued this line of work by focusing on their association with maladaptive behaviors in IPV survivors during each of these two intervals.…”

mentioning

confidence: 99%

The Association Between Posttraumatic Negative Self‐Conscious Cognitions and Emotions and Maladaptive Behaviors: Does Time Since Trauma Exposure Matter?

Tran

Lipinski

Peter

et al. 2019

Journal of Traumatic Stress

View full text Add to dashboard Cite

Negative beliefs about the self, self-blame, guilt, and shame have been consistently linked to emotional problems, such as posttraumatic stress disorder and depression, following trauma exposure. To expand understanding of the potential role of negative self-conscious cognitions and emotions in other forms of posttrauma maladjustments, such as maladaptive behaviors, the current study examined the associations between these cognitions and emotions with dissociation, alcohol use, and avoidant problem-solving. As a secondary goal, the influence of time since trauma exposure was considered given recent data suggesting that some posttraumatic responses require lengthier time following trauma to become salient. Multiple-group analysis was conducted in two groups of female survivors of intimate partner violence (IPV): women whose IPV experiences occurred within 3 months prior to assessment (early posttrauma phase [EPP]; n = 67) and those whose experiences occurred 12 months or more prior to assessment (chronic posttrauma phase [CPP]; n = 145). The results suggested model invariance. Posttraumatic negative self-conscious cognitions and emotions were significantly correlated with dissociation (EPP group: β = .61, p < .001 and CPP group: β = .48, p < .001), alcohol use (EPP group: β = .31, p = .014 and CPP group: β = .30, p < .001), and avoidant problem-solving (EPP group: β = .58, p < .001 and CPP group: β = .56, p < .001). The findings highlight the importance of negative self-conscious cognitions and emotions in posttrauma maladjustment and support intervening in these domains shortly after trauma exposure.

show abstract

“…In addition, distinct clusters may be differentially responsive to various types of psychological intervention, although, in studies to date, researchers have not demonstrated differential effects of therapy by cluster (Horsch et al, 2017; Macdonald, Pukay‐Martin, Wagner, Fredman, & Monson, 2016). PTSD symptoms may be remarkably stable over 3 years without intervention (von Stockert, Fried, Armour, & Pietrzak, 2018). However, the neuroplasticity hypothesis suggests that positive changes in brain circuitry, triggered by therapeutic intervention via medication or therapy, can potentially diminish PTSD symptoms (Musazzi, Tornese, Sala, & Popoli, 2018).…”

Section: Discussionmentioning

confidence: 99%

Associations between changes in resilient coping and posttraumatic stress disorder symptoms

Sinclair

Adams

Dietrich

2020

Research in Nursing & Health

View full text Add to dashboard Cite

show abstract

Evaluating the stability of DSM-5 PTSD symptom network structure in a national sample of U.S. military veterans

Cited by 47 publications

References 39 publications

Symptom structure of PTSD and co-morbid depressive symptoms – a network analysis of combat veteran patients

Symptom structure of PTSD and co-morbid depressive symptoms – a network analysis of combat veteran patients

The Association Between Posttraumatic Negative Self‐Conscious Cognitions and Emotions and Maladaptive Behaviors: Does Time Since Trauma Exposure Matter?

Associations between changes in resilient coping and posttraumatic stress disorder symptoms

Contact Info

Product

Resources

About