Posttraumatic Stress Disorder Symptoms and Positive Affect: Individual and Multi-level Dynamic Networks

Objective. Network analysis aims to identify links between symptoms that may serve to maintain one other; the current study uses network analysis to identify relationships between posttraumatic stress disorder (PTSD) symptoms as they unfold over time within individuals. We also examine whether positive affect (PA) may buffer subsequent PTSD symptoms in daily life and compare single individual networks to the average within-person effects. Method. Fifty-two individuals (76.9% female; 84.6% white) who had experienced a Criterion A trauma participated in the two-week study and reported their PA and PTSD symptom levels five times a day at two-hour intervals (M surveys completed = 60.4). Multi-level and regularized individual-only network models were generated using vector autoregression. Results. Feeling distant from others was the PTSD symptom most closely connected to lower positive affect; it was also the most connected to other PTSD symptoms. PA items did not predict lower PTSD at the next time point, except for one bidirectional relationship. Feeling on edge was the symptom with the largest magnitude of relationships to other symptoms in the multilevel network, but this was only reflected in 38.5% of the individual networks. Three example individual networks are described and discussed for clinical implications. Conclusions. We did not find evidence to support the hypothesis that PA buffers PTSD symptom severity on the time scale assessed (2 hours). Feeling distant from others was a bridge between lower PA and PTSD symptoms and may indicate social support as an important factor in treating trauma survivors.