Category: Transdiagnostic

Symposium

PTSD as a Causal System in Undergraduates and Veterans

Sunday, November 19
10:15 AM - 11:45 AM
Location: Sapphire Ballroom M & N, Level 4, Sapphire Level

Keywords: PTSD Posttraumatic Stress Disorder
Presentation Type: Symposium

Psychological theories of Post Traumatic Stress Disorder (PTSD) suggest that a latent construct causes the symptoms that quantify it.  Recently psychometricians have turned to a different approach to understand mental disorders that characterize them as causal systems (Borsboom & Cramer, 2013).  According to this approach, a stressor (trauma) causes a symptom, which may cause other symptoms and in turn be affected by those symptoms and that these symptoms themselves constitute the mental disorder. For example, McNally et al. (2015) used network analyses of the PTSD symptoms in 362 earthquake survivors (38% met criteria for probable PTSD) showing  that feeling distant from  other people was linked to loss of interest in previously enjoyable activities as well as emotional numbing. In the current study, we replicated and extended these network analyses with a much large sample n= 2292 (1,164 veterans, 1,128 students). First, we used a weighted and directed network, i.e. the magnitude of the relation is shown through thickness of the line, and arrows start at the predictor symptom and end at the predicted symptom. In both samples, the strongest associations were between feeling distant from others and loss of interest in previously enjoyable activities, as well as between sleep difficulty and being easily startled.  Second we used directed acyclic graph (DAG) (via a Bayesian hill-climbing algorithm), an interdisciplinary area with the aim of determining causal inferences from observational data (Pearl, 2014) to examine the causal relationships between symptoms. These analyses suggested that in students the primary causal symptom was hypervigilance whereas the primary causal symptom in the veteran was intrusions. Overall, our network analyses suggest causal system that characterizes PTSD in a large sample with some findings consistent with clinical observations in patients with PTSD while also highlighting unexpected potentially causal relationships that can be the target of intervention in different samples.  

Shaan McGhie

Research Assistant
San Diego State University

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