Journal Article

Changes in the dynamic network structure of PTSD symptoms pre-to-post combat

Segal, Adva, Bar-Haim, Yair, Fruchter, Eyal, Ben Yehuda, Ariel, Wald, Ilan, Ginat, Keren, Pine, Daniel S., Lubin, Gad

2020

Overview

Combat exposure is associated with elevated risk for post-traumatic stress disorder (PTSD). Despite considerable research on PTSD symptom clustering, it remains unknown how symptoms of PTSD re-organize following combat. Network analysis provides a powerful tool to examine such changes. A network analysis approach was taken to examine how symptom networks change from pre- to post-combat using longitudinal prospective data from a cohort of infantry male soldiers (Mage = 18.8 years). PTSD symptoms measured using the PTSD Checklist (PCL) were assessed after 6 months of combat training but before deployment and again after 6 months of combat (Ns = 910 and 725 at pre-deployment and post-combat, respectively). Stronger connectivity between PTSD symptoms was observed post-combat relative to pre-deployment (global strength values of the networks were 7.54 pre v. 7.92 post; S = .38, p < 0.05). Both the re-experiencing symptoms cluster (1.92 v. 2.12; S = .20, p < 0.03) and the avoidance symptoms cluster (2.61 v. 2.96; S = .35, p < 0.005) became more strongly inter-correlated post-combat. Centrality estimation analyses revealed that psychological reaction to triggers was central and linked the intrusion and avoidance sub-clusters at post-combat. The strength of associations between the arousal and reactivity symptoms cluster remained stable over time (1.85 v. 1.83; S = .02, p = .92). Following combat, PTSD symptoms and particularly the re-experiencing and avoidance clusters become more strongly inter-correlated, indicating high centrality of trigger-reactivity symptoms.

• Publisher: Cambridge University Press
• Subject: Adolescent / Adult / Armed Conflicts - psychology / Armed forces / Arousal / Avoidance behavior / Changes / Clustering / Cohort Studies / Combat Disorders - psychology / Combat experience / Commando troops / Connectivity / Deployment / Humans / Intrusion / Israel / Longitudinal Studies / Male / Military Deployment - psychology / Military engagements / Military personnel / Military Personnel - psychology / Military training / Network analysis / Network centrality / Physiology / Post traumatic stress disorder / Prospective Studies / Reactivity / Risk Factors / Soldiers / Stress Disorders, Post-Traumatic - psychology / Symptoms / Trauma / Young Adult