Bridging symptoms of posttraumatic stress disorder, complex posttraumatic stress disorder and posttraumatic growth: a network analysis.

Background Improving our understanding of the symptom-level relationships among posttraumatic stress disorder (PTSD), complex posttraumatic stress disorder (CPTSD), and posttraumatic growth (PTG) holds promise for identifying opportunities for effective interventions.Objective We sought to better understand the network of relationships among symptoms of PTSD and CPTSD, and features of PTG.Method An international online sample of adults who endorsed the experience of at least one traumatic experience (N = 704; 57% women) completed measures of PTSD, CPTSD, and PTG on two occasions, a month apart. We specified three domains of symptoms corresponding to PTSD, CPTSD and PTG, and estimated partial correlation networks and bridge symptoms between these domains. We also assessed the invariance of the network structure across the one-month interval.Results Data and code used for the present analyses are available for verification and further research, consistent with FAIR principles. Stability indices and invariance tests across the one-month interval provided confidence that the network is robust and that the magnitude of edges can be meaningfully interpreted. A majority of the edges between PTSD symptoms and PTG were positive, whereas the majority of edges between CPTSD-specific symptoms and PTG were negative. Bootstrap tests identified symptoms with significantly greater bridge strength than others. These included intrusive memories/images, avoidance of external reminders of trauma, difficulties feeling close to others and changed priorities of what is important in life.Conclusions If further research confirms that these relationships are causal, then there is the intriguing possibility that reducing PTSD symptoms may have the paradoxical effect of potentially undermining PTG. To best promote PTG alongside PTSD/CPTSD, our findings suggest that CPTSD-specific symptoms are more promising intervention targets than PTSD symptoms.Our network analysis of PTSD symptoms, CPTSD symptoms and posttraumatic growth (PTG) demonstrated stability over 1 month.Positive partial correlations between PTSD and PTG items could reflect a threshold effect whereby a minimum level of PTSD may be necessary to provide the conditions for PTG.Targeting CPTSD-specific bridge symptoms rather than PTSD bridge symptoms may result in the most favourable outcomes for the overall symptom network.Data and code for the present analyses are Findable, Accessible, Interoperative and Reusable (FAIR) on the Open Science Framework.