An examination of idiographic networks of posttraumatic stress disorder symptoms

Although applying network theory to posttraumatic stress disorder (PTSD) has yielded promising insights, the lack of equivalence between inter- and intraindividual variation limits the generalizability of these findings to any one individual with PTSD. Better understanding how PTSD symptoms occur and vary over time within an individual instead requires exploring the idiographic network structure of PTSD. To do so, the present study used an intensive repeated measures design to estimate intraindividual networks of PTSD symptoms on a person-by-person basis. Twenty individuals (N = 20) who met criteria for PTSD completed daily surveys assessing PTSD symptoms four times per day for approximately 30 days. Employing a recently validated method provided by Fisher, Reeves, Lawyer, Medaglia, and Rubel (2017), we then used these data to estimate a contemporaneous and temporal network of PTSD symptoms for each individual on a person-by-person basis. We then calculated centrality metrics to determine the relative importance of each symptom in each idiographic network. Across all contemporaneous networks, negative trauma-related cognitions and emotions tended to most commonly be the most central symptoms. Further, across all temporal networks, (a) negative trauma-related emotions were the most common driver of variation in other symptoms over time and (b) distressing trauma-related dreams and sleep disturbance were the most common downstream consequences of variation in other PTSD symptoms over time. Finally, we also review data from two randomly selected participants to illustrate how this approach could be used to identify maintenance factors of PTSD for each individual and guide individual treatment planning.