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The Complex Network Perspective on the Nosology of Posttraumatic Stress Disorder and Co-Occurring Pathology
According to the network perspective on psychopathology, PTSD is an emergent property of a dynamical system resulting from the causal interplay among symptoms. Moving beyond diagnostic boundaries, the network perspective promises to revolutionize clinical intervention by identifying and intervening on symptoms with high influence that, if turned off, should result in a therapeutic cascade of symptom reduction. Adopting the network perspective, the aim of the present project seeks to identify influential symptoms within PTSD and co-occurring conditions. Utilizing network analytic methodology in the first study, I examined how individual symptoms of PTSD and aspects of emotion dysregulation interrelate among a sample of trauma-exposed women. In the PTSD and emotion dysregulation network, the node concentration difficulties had high influence and acts as a bridge between other PTSD symptoms and aspects of emotion dysregulation. Addressing the noted limitations of the first study, the second study sought to examine comorbidity between PTSD and depression symptoms among disaster-exposed adolescents. Using confirmatory factor analysis, I estimated the latent factor structure and found that the PTSD and depression factors were largely indistinguishable. Implementing latent class analysis to identify subgroups of individuals, I found that subgroups experienced both PTSD and depression symptoms, and distinctions between groups were due to differences in symptom severity. Subsequently, I utilized network and found that symptoms did not cluster together by diagnostic category. Overall, the present study did not find compelling evidence for distinct boundaries between PTSD and depression. Building on the second study, I sought to identify how a combined PTSD and depression symptom networks change from pre- to post-treatment. Testing the clinical utility of network metrics revealed that node metrics at pretreatment strongly predicted overall PTSD and depression network change observed in treatment. Findings from this study indicate that changes in network structure following treatment is strongly associated with a symptom’s centrality in the pretreatment network. Overall, these analyses highlight the importance of analyzing symptoms beyond diagnoses to inform priority targets for treatment. Future work should consider moving beyond symptom networks to produce therapeutic cascades within community and social networks.
Clinical psychology|Experimental psychology
Haws, James Kyle, "The Complex Network Perspective on the Nosology of Posttraumatic Stress Disorder and Co-Occurring Pathology" (2022). ETD collection for University of Nebraska - Lincoln. AAI28768177.