Post-traumatic stress symptoms in women with a history of sexual trauma: A network approach

• DSM-5 PTSD symptom structure in sexual trauma survivors is unclear. • Negative emotional state and exaggerated startle are central PTSD symptoms. • Strong links found between avoidance symptoms and hypervigilance-startle. • Network analysis reveals potential symptom redundancies in PTSD. Post-traumatic stress disorder (PTSD) is a common outcome of sexual violence. Network analysis offers a novel approach to examine symptom interactions, though prior research in sexual trauma survivors has shown instability of centrality metrics. This study examined the DSM-5 PTSD symptom network in women with sexual trauma histories, focusing on symptom communities, central symptoms, and strong edges. 313 women (ages 18–58, M = 31.34), mainly survivors of child sexual abuse, completed the PTSD Checklist for DSM-5 (PCL-5). A Gaussian Graphical Model with GLASSO regularization estimated the network; community detection and node centrality were assessed. The DSM-5 structure lacked clear support, with some Cluster D symptoms aligning with Cluster E. Strong associations emerged between the avoidance symptoms and between hypervigilance and exaggerated startle. Negative emotional state and exaggerated startle were the most central and predictable symptoms; memory impairment was the least. PTSD symptom structure in sexually traumatized women may not align with DSM-5 clusters. Central symptoms like negative emotion and exaggerated startle may be key intervention targets. Longitudinal research is needed to clarify symptom dynamics.