Post-Traumatic Stress Disorder and Self-Injurious Thoughts and Behaviors: Exploratory Network Analysis and Network Comparison Test in Two Trauma-Exposed Samples

Abstract

Pre-existing psychopathology, such as post-traumatic stress disorder (PTSD), is a well-established risk factor for self-injurious thoughts and behaviors (SITBs). However, previous studies examining the link between PTSD and SITBs have had mixed results, likely due to their limited ability to capture the complexities of both phenomena. Network analysis is an advanced statistical method that is equipped to account for these complexities. To date, several exploratory networks on PTSD and SITBs have been estimated; however, formal replication of these exploratory network structures has not been conducted. Thus, in the current study, we estimated an exploratory network of DSM-5 PTSD symptoms and SITBs (i.e., suicidal ideation, non-suicidal self-injury, and suicidal behaviors) in a trauma-exposed sample (N=893) and identified relevant bridge symptoms through measures of bridge centrality. Then, we assessed replicability of findings by employing a network comparison test with a second trauma-exposed sample (N=367). Risky or self-destructive behavior and negative beliefs about the self, world, and others emerged as prominent bridge symptoms for PTSD. Suicidal ideation emerged as a prominent bridge symptom for SITBs. Moreover, network comparison test results showed that across all measurement indices, the two networks were not statistically different from each other. Results from our study are consistent with previous studies that have found the PTSD symptoms of risky and self-destructive behaviors and negative beliefs about the self, world, and others to be most related to SITBs, specifically suicidal ideation. This evidence allows for the identification of treatment targets to disrupt the PTSD-SITB symptom presentation.