Citation

Levin Y, Hyland P, Karatzias T, Shevlin M, Bachem R, Maercker A, Ben-Ezra M. J. Psychiatr. Res. 2021; 136: 80-86.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.jpsychires.2021.01.041

PMID

unavailable

Abstract

BACKGROUND: Symptom network analysis has become an essential tool for researchers and clinicians investigating the structure of mental disorders. Two methods have been used; one relies on partial correlations, and the second relies on zero order correlations with forced-directed algorithm. This combination was used to examine symptom connections for ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) as the symptoms for these disorders have been known to be organized in a multi-dimensional and hierarchical fashion. We aimed to examine whether networks of ICD-11 CPTSD symptoms reproduced across samples from three African countries.

METHODS: We produced network models based on data from 2524 participants in Nigeria (n = 1018), Kenya (n = 1006), and Ghana (n = 500). PTSD and CPTSD symptoms were measured using the International Trauma Questionnaire (Cloitre et al., 2018).

RESULTS: The CPTSD network analysis using force-directed method alongside partial correlations based on Gaussian Graphical Models (GGM) revealed the multidimensional-hierarchal structure of CPTSD. The within-cluster symptoms of Disturbances in Self Organization (DSO) and PTSD were strongly correlated with each other in all networks, and the cross-cluster symptoms were lower. The most central symptom was 'feelings of worthlessness', a symptom of Negative Self-Concept that is part of the CPTSD cluster. The networks were very similar across the three countries.

CONCLUSIONS: Findings support the ICD-11 model of PTSD and CPTSD in three African countries.

Language: en

Keywords

Trauma; PTSD; Methodology; CPTSD; Stress related disorders