The importance of theDSM‐5posttraumatic stress disorder symptoms of cognitions and mood in traumatized children and adolescents: two network approaches

Abstract

Background The aim of this study is to provide a better understanding of the central symptoms of DSM‐5 posttraumatic stress disorder (PTSD) in children and adolescents from the perspective of the child and its caregiver. Identifying core symptoms of PTSD can help clinicians to understand what may be relevant targets for treatment. PTSD may present itself differently in children and adolescents compared to adults, and no study so far has investigated the DSM‐5 PTSD conceptualization using network analysis. Methods The network structure of DSM‐5 PTSD was investigated in a clinical sample of n = 475 self‐reports of children and adolescents and n = 424 caregiver‐reports using (a) regularized partial correlation models and (b) a Bayesian approach computing directed acyclic graphs (DAGs). Results (a) The 20 DSM‐5 PTSD symptoms were positively connected within the self‐report and the caregiver‐report sample. The most central symptoms were negative trauma‐related cognitions and persistent negative emotional state for the self‐report and negative trauma‐related cognitions, intrusive thoughts or memories and exaggerated startle response for the caregiver‐report. (b) Similarly, symptoms in the negative alterations in cognitions and mood cluster (NACM) have emerged as key drivers of other symptoms in traumatized children and adolescents. Conclusions As the symptoms in the DSM‐5 NACM cluster were central in our regularized partial correlation networks and also appeared to be the driving forces in the DAGs, these might represent important symptoms within PTSD symptomatology and may offer key targets in PTSD treatment for children and adolescents.

Dysfunctional posttraumatic cognitions, posttraumatic stress and depression in children and adolescents exposed to trauma: a network analysis

“…Most of the participants in Bartels et al. 's study () reported interpersonal trauma (55.5%) compared with 18.9% in our sample. Furthermore, in line with our findings, strong physical sensations had previously emerged as a central symptom in another network analysis of PTSD symptoms in children and adolescents exposed to disasters (Russell, Neill, Carrion, & Weems, ).…”

“…Using DSM‐5 PTSD symptoms, Bartels et al. () found that symptoms of the negative alterations in cognitions and mood cluster emerged as central in their network. However, also psychological distress (B4, DSM‐5) and avoidance of thoughts or memories (C1, DSM‐5) emerged as central.…”

Editorial: The psychopathology p factor: will it revolutionise the science and practice of child and adolescent psychiatry?

“…Bartels et al. employ, amongst other things, a Bayesian approach to model directed acyclic graphs of post‐traumatic stress disorder (PTSD) symptoms in children and adolescents (Bartels et al., ). They demonstrate which symptoms of PTSD are the key drivers of other symptoms within PTSD and thus are able to advise, based on their data, which symptoms would be the optimal targets for treatment.…”

Improving Mental Health Care for Unaccompanied Young Refugees through a Stepped Care Approach versus Usual Care+: Study Protocol of a Cluster Randomized Controlled Hybrid Effectiveness Implementation Trial

“…No exclusion criteria have been de ned for participants in the RCT. 4. To assess the costs of care for UYRs and the cost utility of the BETTER CARE model in comparison to usual care+.…”