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.