From Network Structure to Symptom Targets: A Network Analysis With Computer-Simulated Intervention for the Co-Occurrence of PTSD, Depression, and Anxiety Symptoms in Police Officers

As first responders, police officers are frequently exposed to traumatic events involving severe interpersonal violence, posing unique psychological challenges. Although posttraumatic stress disorder (PTSD) has been extensively studied, little is known about its co-occurrence with depression and anxiety symptoms among police officers. Clarifying this co-occurrence may offer important insights into the complex interplay between trauma-related and affective symptoms in high-risk professional populations. Based on the network perspective of psychopathology, this study used network analysis and computer-simulated intervention, operationalized as computer-simulated symptom perturbation analysis, to identify potential targets that may be prioritized for future clinical attention within the co-occurring symptom network. A total of 2,156 police officers participated in this study ( M age = 35.96, SD = 7.95). The results showed that feeling “Jumpy and startled” (IES10) had the highest strength and bridge strength values, suggesting that this symptom was key in the overall network and linked PTSD symptoms with depression and anxiety symptoms. In the computer-simulated interventions, decreasing the activation threshold of “Avoided upset” (IES5) produced the largest projected alleviating effect, whereas increasing the activation threshold of “Jumpy and startled” (IES10) produced the largest projected aggravating effect, indicating that these symptoms may be clinically informative indicators for future assessment and mental health support. These findings suggest that avoidance-related symptoms may be relevant to treatment-oriented intervention development, whereas startle-related hyperarousal may be useful for prevention-oriented monitoring and early support. Symptoms with strong network connections are not necessarily the same symptoms that produce the greatest projected change when targeted. Combining symptom network analysis with computer-simulated intervention approaches may provide a more informative way to identify symptoms with distinct roles in the co-occurring symptom network. This study deepens our understanding of how PTSD, depression, and anxiety symptoms co-occur among police officers and highlights the need for culturally sensitive and occupation-specific mental health strategies.