Research Service, VA Boston Healthcare System.
Behavioral Sciences Division, Department of Veterans Affairs Boston National Center for Posttraumatic Stress Disorder.
J Abnorm Psychol. 2018 Aug;127(6):541-547. doi: 10.1037/abn0000368.
Network theory, which conceptualizes psychiatric disorders as networks of interacting symptoms, may provide a useful framework for understanding psychopathology. However, questions have arisen regarding the stability and generalizability of network analytic methods, with some researchers arguing that symptom networks have limited replicability. The aim of this study was to evaluate assessment modality as one possible source of instability in the estimation of posttraumatic stress disorder (PTSD) symptom networks. We estimated two cross-sectional DSM-5 PTSD symptom networks in 378 U.S. veterans: one using data from a clinician-rated assessment instrument (Clinician-Administered PTSD Scale for DSM-5; CAPS-5) and one using data from a self-rated questionnaire (the PTSD Checklist for DSM-5; PCL-5). We calculated centrality indices, conducted community structure analyses, and compared the strength and structure of the networks. The CAPS-5 and PCL-5 symptom networks were highly similar, challenging the notion that network methods produce unreliable results due to estimations consisting primarily of measurement error. Furthermore, each network contained distinct symptom communities that only partially overlapped with the DSM-5 PTSD symptom clusters. These findings may provide guidance for future revisions of the DSM, suggest hypotheses about how PTSD symptoms interact, and inform recent debate about replicability of psychopathology symptom networks. (PsycINFO Database Record
网络理论将精神障碍概念化为相互作用的症状网络，可能为理解精神病理学提供有用的框架。然而，关于网络分析方法的稳定性和普遍性的问题已经出现，一些研究人员认为症状网络的可重复性有限。本研究旨在评估评估方式是否是 PTSD 症状网络估计中不稳定的一个可能来源。我们在 378 名美国退伍军人中估计了两个横断面 DSM-5 PTSD 症状网络：一个使用来自临床医生评定的评估工具（DSM-5 创伤后应激障碍临床医生评定量表；CAPS-5）的数据，另一个使用来自自我评定问卷（DSM-5 创伤后应激障碍检查表；PCL-5）的数据。我们计算了中心性指数，进行了社区结构分析，并比较了网络的强度和结构。CAPS-5 和 PCL-5 症状网络非常相似，这挑战了网络方法由于主要由测量误差组成而产生不可靠结果的观点。此外，每个网络都包含独特的症状社区，这些社区仅与 DSM-5 PTSD 症状群部分重叠。这些发现可能为 DSM 的未来修订提供指导，提出关于 PTSD 症状如何相互作用的假设，并为最近关于精神病理学症状网络可重复性的争论提供信息。
