A network analysis of posttraumatic stress disorder and dissociation in trauma-exposed adolescents

Abstract

Posttraumatic stress disorder (PTSD) and dissociation have long been recognized to co-occur, leading the DSM-5 to introduce a dissociative subtype of PTSD into its nomenclature. Most research to date on the dissociative subtype has focused on adults. The current study aimed to extend this research to an adolescent sample and to examine symptom-level associations between PTSD and dissociation using network analysis. The analysis was conducted with 448 trauma-exposed detained US adolescents (24.55% female; mean age 15.98 ± 1.25 years). A network consisting of 20 DSM-5 PTSD symptoms was constructed, followed by a network consisting of 20 PTSD symptoms and five dissociative items. Expected influence bridge centrality was estimated to examine items with the most/strongest cross-construct connections (i.e. between PTSD and dissociation). The PTSD symptoms concentration problems, amnesia and recurrent memories and the dissociative items depersonalization, derealisation and can't remember things that happened had the highest bridge centrality values. These symptom-level associations extend our understanding of the PTSD-dissociation relationship by pointing to specific symptoms of PTSD and dissociation that may drive the co-morbidity between the two constructs. These findings may inform future intervention efforts.

Keywords: Adolescents; Dissociation; Dissociative subtype; Network analysis; PTSD; Youth.