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Clinical Psychology & Psychotherapy
Article . 2025 . Peer-reviewed
License: CC BY NC ND
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The Association of Posttraumatic Stress Disorder, Complex Posttraumatic Stress Disorder and Depression: A Network Approach

Authors: Yihan Gai; David Berle;

The Association of Posttraumatic Stress Disorder, Complex Posttraumatic Stress Disorder and Depression: A Network Approach

Abstract

ABSTRACT Background Complex posttraumatic stress disorder (CPTSD) is a newly recognized condition in the ICD‐11, characterized by the core symptoms of PTSD alongside disturbances in self‐organization (DSO). Network analysis provides a novel approach to understanding the complex relationships between symptoms. While many studies have identified the comorbidity between PTSD/CPTSD and depression, few have focused on CPTSD using network analysis. This study aims to investigate the bridge symptoms between PTSD, DSO and depression. Method A sample of 385 US participants who reported at least one lifetime trauma completed the ICD‐11 International Trauma Questionnaire (ITQ) and the Patient Health Questionnaire‐9 (PHQ‐9). Results The obtained network models were stable. The most central symptoms were ‘Feeling distant or cut off from people’, ‘Feeling down, depressed, or hopeless’ and ‘Feeling like a failure’. The key bridge symptoms in the network were ‘Negative self‐concept’, ‘Feeling like a failure’, ‘When I am upset, it takes me a long time to calm down’ and ‘Finding it hard to stay emotionally close to people’. Conclusions The results indicate that certain symptoms are considerably more influential within the network. Affective, identity and interpersonal DSO symptoms may play a key role in linking PTSD and depression. These symptoms may be important targets for interventions.

Keywords

Stress Disorders, Post-Traumatic, Male, Adult, Depressive Disorder, Young Adult, International Classification of Diseases, Surveys and Questionnaires, Humans, Female, Comorbidity, Middle Aged, Self Concept, Research Article

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
Green
hybrid