Comparing the network structure of ICD-11 PTSD and complex PTSD in three African countries  

Levin, Yafit; Hyland, Philip; Karatzias, Thanos; Shevlin, Mark; Ben-Ezra, Menachem

Abstract

Background: Symptom network analysis has become an essential tool for researchers and clinicians investigating the structure of mental disorders. Two methods have been used; one relies on partial correlations, and the second relies on zero order correlations with forced-directed algorithm. This combination was used to examine symptom connections for ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) as the symptoms for these disorders have been known to be organized in a multi-dimensional and hierarchical fashion. We aimed to examine whether networks of ICD-11 CPTSD symptoms reproduced across samples from three African countries. Methods: We produced network models based on data from 2,524 participants in Nigeria (n = 1018), Kenya (n = 1006), and Ghana (n = 500). PTSD and CPTSD symptoms were measured using the International Trauma Questionnaire (Cloitre et al., 2018). Results: The CPTSD network analysis using force-directed method alongside partial correlations based on Gaussian Graphical Models (GGM) revealed the multidimensional-hierarchal structure of CPTSD. The within-cluster symptoms of Disturbances in Self Organization (DSO) and PTSD were strongly correlated with each other in all networks, and the cross-cluster symptoms were lower. The most central symptom was ‘feelings of worthlessness’, a symptom of Negative Self-Concept that is part of the CPTSD cluster. The networks were very similar across the three countries. Conclusions: Findings support the ICD-11 model of PTSD and CPTSD in three African countries.

• Journal Article Type: Article
• Acceptance Date: Jan 22, 2021
• Online Publication Date: Jan 25, 2021
• Publication Date: 2021-04
• Deposit Date: Jan 27, 2021
• Publicly Available Date: Jan 26, 2022
• Print ISSN: 0022-3956
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 136
• Pages: 80-86
• DOI: https://doi.org/10.1016/j.jpsychires.2021.01.041
• Keywords: Trauma; PTSD; CPTSD; Stress related Disorders; Methodology
• Public URL: http://researchrepository.napier.ac.uk/Output/2717982