A network analysis of psychosocial functioning and posttraumatic stress disorder and depression symptoms in a nationally representative US Veteran cohort

Abstract: Objective: Posttraumatic stress disorder and depression adversely affect psychosocial functioning, both separately and especially when they co-occur. Despite the high prevalence of these conditions in veterans, it is unclear which specific posttraumatic stress disorder and depression symptoms contribute most to psychosocial functioning impairment. Network analysis can help elucidate these associations by examining symptoms and functioning difficulties as components of a dynamic system. Method: Using cross-sectional data from 3,847 trauma-exposed U.S. veterans in the National Health and Resilience in Veterans Study, we constructed a Gaussian graphical model of individual posttraumatic stress disorder and depression symptoms and psychosocial functioning impairment. Results: The cardinal symptoms of depression-anhedonia and depressed mood-showed the strongest associations with functioning impairment, followed by restricted affect, suicidal ideation, and irritability/anger. Conclusions: These five symptoms may serve as potential targets of interventions to bolster psychosocial functioning among trauma-exposed veterans. Future research should include the application of network models to intensive longitudinal data to gain insights into whether these symptoms may have a causal role in impairing psychosocial functioning.

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