Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA.
J Trauma Stress. 2020 Feb;33(1):116-125. doi: 10.1002/jts.22482. Epub 2020 Feb 15.
This commentary on the Journal of Traumatic Stress special issue on network analysis explores the network perspective on posttraumatic stress disorder (PTSD), emphasizing the advances in research made in this collection of articles. The commentary is organized around the following themes related to actualizing the perspective's methodological, assessment, and intervention potential and the potential shift in the theoretical underpinnings of mental disorders that networks models imply. First, extant data using network analysis suggest that reactions to traumatic stress are more complicated than once thought but that this complexity does not mean efficient, relatively simple heuristics to aid assessment and intervention do not exist. Attention to methodological issues in symptom assessment may help move this aspect of the research forward. Second, the extant research is largely correlational and has not yet established causal linkages, although temporal associations underlying network models are being identified. Prospective and intervention studies employing network analysis are critical. Third, the network perspective of PTSD symptoms may advance research on the mechanisms of risk and resilience (e.g., neurodevelopmental, cognitive behavioral, emotional, and social models) by helping link symptoms to theoretical causal processes. A developmental framework that views the effect of traumatic stress in terms of temporal cascades of reactions with both negative and potentially positive cognitive, behavioral, social, and emotional outcomes fits the network analysis model. Fourth, network models call into question some of the fundamental assumptions underlying the conceptualization of mental disorders, leaving several ontological questions and implications currently unanswered; research examining the implications of the new assumptions is needed.
这篇关于《创伤应激杂志》网络分析特刊的评论探讨了创伤后应激障碍 (PTSD) 的网络视角，强调了本系列文章在研究方面的进展。评论围绕以下主题展开，这些主题与实现该视角的方法学、评估和干预潜力以及网络模型所暗示的精神障碍理论基础的潜在转变有关。首先，使用网络分析的现有数据表明，对创伤应激的反应比以前认为的要复杂，但这种复杂性并不意味着不存在有助于评估和干预的有效、相对简单的启发式方法。关注症状评估中的方法学问题可能有助于推动这方面的研究。其次，现有研究主要是相关性研究，尚未建立因果关系，尽管正在确定网络模型背后的时间关联。采用网络分析的前瞻性和干预性研究至关重要。第三，PTSD 症状的网络视角可以通过将症状与理论因果过程联系起来，从而推进风险和弹性的机制研究（例如，神经发育、认知行为、情感和社会模型）。从时间上看，创伤应激的影响可以看作是一系列反应的级联，既有负面的，也有潜在的积极的认知、行为、社会和情感结果，这种发展框架符合网络分析模型。第四，网络模型对精神障碍概念化的一些基本假设提出了质疑，留下了一些目前尚未回答的本体论问题和影响；需要研究检查新假设的影响。
