The Network Structure of Posttraumatic Stress Symptoms in Children and Adolescents Exposed to Disasters

Russell, Justin D.; Neill, Erin L.; Carrión, Victor G.; Weems, Carl F.

doi:10.1016/j.jaac.2017.05.021

Cited by 67 publications

(72 citation statements)

References 51 publications

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“…'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, ). In a sample of disaster‐exposed adolescents, Cao et al.…”

Section: Discussionsupporting

confidence: 91%

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

Haan

Landolt

Fried

et al. 2019

Child Psychology Psychiatry

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Background The latest version of the International Classification of Diseases (ICD‐11) proposes a posttraumatic stress disorder (PTSD) diagnosis reduced to its core symptoms within the symptom clusters re‐experiencing, avoidance and hyperarousal. Since children and adolescents often show a variety of internalizing and externalizing symptoms in the aftermath of traumatic events, the question arises whether such a conceptualization of the PTSD diagnosis is supported in children and adolescents. Furthermore, although dysfunctional posttraumatic cognitions (PTCs) appear to play an important role in the development and persistence of PTSD in children and adolescents, their function within diagnostic frameworks requires clarification. Methods We compiled a large international data set of 2,313 children and adolescents aged 6 to 18 years exposed to trauma and calculated a network model including dysfunctional PTCs, PTSD core symptoms and depression symptoms. Central items and relations between constructs were investigated. Results The PTSD re‐experiencing symptoms strong or overwhelming emotions and strong physical sensations and the depression symptom difficulty concentrating emerged as most central. Items from the same construct were more strongly connected with each other than with items from the other constructs. Dysfunctional PTCs were not more strongly connected to core PTSD symptoms than to depression symptoms. Conclusions Our findings provide support that a PTSD diagnosis reduced to its core symptoms could help to disentangle PTSD, depression and dysfunctional PTCs. Using longitudinal data and complementing between‐subject with within‐subject analyses might provide further insight into the relationship between dysfunctional PTCs, PTSD and depression.

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Section: Discussionsupporting

confidence: 91%

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

Haan

Landolt

Fried

et al. 2019

Child Psychology Psychiatry

View full text Add to dashboard Cite

show abstract

“…Interestingly, 1 study showed that connections may vary in different age groups, that is, symptoms such as “amnesia” and “numbness of negative effect” were more strongly associated in children than in the adolescents [36]. In addition, in the only longitudinal study that compared networks across time, Bryant et al [31] found that, after 1 year, re-experiencing symptoms were more strongly connected than during the acute phase and that physiological reactivity was strongly associated with startle response which, in turn, was associated with hypervigilance.…”

Section: Resultsmentioning

confidence: 99%

The Study of Psychopathology from the Network Analysis Perspective: A Systematic Review

Contreras

Nieto

Valiente

et al. 2019

Psychother Psychosom

283

214

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Background: Network analysis (NA) is an analytical tool that allows one to explore the map of connections and eventual dynamic influences among symptoms and other elements of mental disorders. In recent years, the use of NA in psychopathology has rapidly grown, which calls for a systematic and critical analysis of its clinical utility. Methods: Following PRISMA guidelines, a systematic review of published empirical studies applying NA in psychopathology, between 2010 and 2017, was conducted. We included the literature published in PubMed and PsycINFO using as keywords any combination of “network analysis” with the terms “anxiety,” “affective disorders,” “depression,” “schizophrenia,” “psychosis,” “personality disorders,” “substance abuse” and “psychopathology.” Results: The review showed that NA has been applied in a plethora of mental disorders in adults (i.e., 13 studies on anxiety disorders; 19 on mood disorders; 7 on psychosis; 1 on substance abuse; 1 on borderline personality disorder; 18 on the association of symptoms between disorders), and 6 on childhood and adolescence. Conclusions: A critical examination of the results of each study suggests that NA helps to identify, in an innovative way, important aspects of psychopathology like the centrality of the symptoms in a given disorder as well as the mutual dynamics among symptoms. Yet, despite these promising results, the clinical utility of NA is still uncertain as there are important limitations on the analytic procedures (e.g., reliability of indices), the type of data included (e.g., typically restricted to secondary analysis of already published data), and ultimately, the psychometric and clinical validity of the results.

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“…Only one network analytic investigation of PTSS has been conducted to date with children and adolescents. Russell, Neill, Carrión, and Weems () evaluated the underlying network structure of DSM‐IV PTSS in a cross‐sectional sample of children and adolescents exposed to Hurricanes Katrina and Gustav based on self‐reports. Examining the influence of each node within the networks, they found that physiological reactivity and avoiding activities were central in the child network and numbness, nightmares, foreshortened future, physiological reactivity, and avoiding activities were central in the adolescent network.…”

Section: Introductionmentioning

confidence: 99%

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

Bartels

Berliner²,

Holt

et al. 2019

Child Psychology Psychiatry

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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.

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The Network Structure of Posttraumatic Stress Symptoms in Children and Adolescents Exposed to Disasters

Cited by 67 publications

References 51 publications

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

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

The Study of Psychopathology from the Network Analysis Perspective: A Systematic Review

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

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