(PS9-24) Posttraumatic Stress Disorder and Self-Injurious Thoughts and Behaviors: Exploratory Network Analysis and Network Comparison Test in Two Trauma-Exposed Samples.

Abstract Text: Pre-existing psychopathology, such as post-traumatic stress disorder (PTSD), is a well-established factor for self-injurious thoughts and behaviors (SITBs). However, previous studies examining the link between PTSD and SITBs have had mixed results, likely due to their limited ability to capture the complexities of both PTSD and SITBs and the mechanisms that maintain their comorbidity. Along with changes in diagnostic criteria for PTSD between the DSM-IV and the DSM-5, past literature frequently characterized PTSD at the symptom cluster level, which does not fully capture how complex the disorder is. Additionally, most studies that characterized PTSD at the item level employed traditional statistical methods, which may be too limited in fully understanding how symptoms interact and maintain each other. Network analysis is an advanced statistical method that can better model the complexities of PTSD at the item level and SITBs, helping identify how the two are connected. Several exploratory networks on PTSD and SITBs have been estimated; however, to date, formal replication of these exploratory network structures has not been conducted. Thus, in the current study, we estimated an exploratory network of DSM-5 PTSD symptoms and SITBs (i.e., suicidal ideation, non-suicidal self-injury, and suicidal behaviors) in a trauma-exposed sample (N=893) to determine which symptoms of PTSD and SITBs “bridge” the two psychological phenomena using measures of bridge centrality. Then, we assessed replicability of findings by employing a network comparison test (i.e., statistical measures of invariance between two network models) with a second trauma-exposed sample (N=367). Across both samples, the symptoms of risky and self-destructive behaviors emerged as the most prominent PTSD bridge symptom, and the SITB symptom of suicidal ideation emerged as the most prominent bridge symptom. Additionally, in Sample 1, the PTSD symptom of negative beliefs about the self, world, and others emerged as a prominent bridge symptom. Moreover, network comparison test results showed that across all measurement indices, the two networks were not statistically different from each other. Results from our study are consistent with previous studies that have found the PTSD symptoms of risky and self-destructive behaviors and negative beliefs about the self, world, and others to be most related to SITBs, specifically suicidal ideation. This evidence allows for the identification of treatment targets to disrupt the PTSD-SITB symptom presentation.