A Network Analysis Exploration of PTSD, Depression, Somatic Complaints, and Anxiety Disorders in a Colombian Sample of Victims of the Armed Conflict

Background
Several studies have explored posttraumatic stress disorder (PTSD) and its comorbidities focusing on shared processes among diagnoses or association between disorder dimensions. Nevertheless, these studies consider disorders as categorical entities ignoring the heterogeneity of said psychopathology.

Objectives
Our study aims to identify how symptoms of PTSD, depression, anxiety, and somatic complaints relate to the symptoms level in victims of armed conflict in Colombia.

Method
Cross-sectional data from 258 participants from a Colombian randomized controlled trial was used to estimate a network at the scale level and a second network at the item level. The expected influence centrality, bridge centrality, accuracy, and stability were calculated.

Results
At the scale level reexperiencing, anxiety, and numbing were the most central nodes; the most central bridge nodes at this level were numbing, PHQ9 cognitive-affective dimension, and PHQ anxiety. At the symptom level, nervous/anxious, depressed/hopeless, troubles concentrating, trauma memories, fear/anger/guilt, and experiencing little pleasure were the most central nodes. Additionally, the most central bridge nodes at this level were nervous/anxious, fear/anger/guilt, experiencing no positive feelings, and feeling depressed and hopeless.

Limitations
Cross-sectional data provides valuable but limited information of transdiagnostic processes. Furthermore, our sample size limited our ability to estimate a full symptom network. Our dataset did not include psychological processes measurements.

Conclusions
Different paths connect PTSD to anxiety, depression, and somatic complaints. Results suggest that victims of armed conflict experience PTSD not only with anxiety features but also depression-related features that might be tied to negative emotions such as anger, shame, and guilt.