A Network Approach to Posttraumatic Stress Disorder: Comparing Interview and Self-Report Networks

Abstract

Objective: Trauma-related fear (e.g., reexperiencing), impaired reward (e.g., anhedonia), and interpersonal (e.g., detachment) processes may be functionally intertwined, giving rise to chronic psychopathology after a trauma. Network analyses can help pinpoint symptom drivers and treatment targets, but studies examining posttraumatic stress disorder (PTSD) treatment-seeking individuals are lacking. Method: Treatment-seeking adults with primary PTSD (N = 350) completed interview and self-report measures of PTSD severity (PSS-I; PSS-SR). Self-report and interview-based networks were estimated and compared. Results: Both networks suggested distinct but interconnected communities of reexperiencing and dysphoric symptoms (e.g., interpersonal detachment, numbing). Centrality profiles were strongly associated across networks (rs =.71), with cued reexperiencing and interpersonal detachment showing strong centrality. Self-reported symptoms were more interconnected, suggesting lower specificity. Conclusions: For those seeking treatment, interrelated fear and interpersonal processes may drive functional impairment in PTSD, and interview-based networks may help better delineate influential symptoms. Therapeutically, targeting cued reexperiencing and interpersonal detachment may facilitate broader symptom decreases.