A network analysis of ICD-11 complex posttraumatic stress disorder symptoms in Danish treatment-seeking military veterans

Network analysis has been extensively used to study posttraumatic stress disorder (PTSD), but only a few studies have examined the network structure of ICD-11 complex PTSD (CPTSD). Currently, no networks of all CPTSD symptoms have been estimated on military samples. Therefore, this study aims to (1) explore the connections of CPTSD symptoms and (2) identify the most central symptoms in a clinical sample of military veterans presenting with CPTSD symptomatology. Danish treatment-seeking soldiers and veterans completed the International Trauma Questionnaire prior to commencing treatment at the Military Psychology Department in the Danish Defense. Network psychometrics were used to analyze the symptom structure and centrality strength index of self-reported CPTSD symptoms in veterans meeting criteria for CPTSD (N = 279). Stability of our results was assessed following the recommended guidelines to ensure reliability. Consistent with prior research, symptoms within the same CPTSD cluster were most strongly connected, except for affective dysregulation. Across all CPTSD symptoms, ‘external avoidance’ and ‘feelings of worthlessness’ emerged as the most central. These findings are consistent with prior networks reported in non-military samples (e.g., community samples) and may support the generalizability of the CPTSD symptom network across trauma-exposed groups. Not applicable.