Rønning Line, Zelkowitz Rachel L, Piccirillo Marilyn L, Liu Jianlin, Thomas Jordan L, Guler Jessy, Kyei J Joana, Hoeboer Chris M, Karchoud Jeanet F, Olff Miranda, Witteveen Anke B, van Zuiden Mirjam
Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.
Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
Eur J Psychotraumatol. 2025 Dec;16(1):2448385. doi: 10.1080/20008066.2024.2448385. Epub 2025 Jan 23.
Despite known gender/sex differences in the prevalence of posttraumatic stress disorder (PTSD), potential differences in the associations among PTSD symptoms between men and women in the early post-trauma period are not well-characterized. This study utilized network analysis to assess potential differences in the associations among PTSD symptom clusters between men and women during the early post-trauma period. We included = 475 participants (57.5% self-identified women) who recently (≤2 months) experienced an interpersonal or motor vehicle potential traumatic event in the Netherlands. Past month PTSD symptoms were measured with the PTSD Checklist for DSM-5 (PCL-5) and composited according to the five-node PTSD symptom cluster dysphoric arousal model. We estimated the network as well as indices of centrality (strength and predictability) and assessed the stability of the modelled networks in subsamples of men (= 202) and women (= 273). We compared network structures using the Network Comparison Test (NCT). Results largely demonstrated adequate correlation stability for the estimated network structures for women and men. For both men and women, avoidance symptoms were among the strongest nodes with greatest predictability in the networks. In men, anxious arousal additionally showed high strength whereas re-experiencing showed high predictability. In women, re-experiencing symptoms demonstrated both high strength and predictability. The NCT demonstrated nonsignificant differences in global network structure (= 0.08, = .054) and strength ( = .073, = .067). Post hoc comparisons showed an association of re-experiencing symptoms with negative alterations in cognitions and mood in men but not women ( = .038, = .005). Results demonstrated possible modest gender differences in aspects of network structure although most elements of the network structure were similar across genders. These results help to characterize gender differences in associations among PTSD symptom clusters during the early post-trauma period, which may inform the potential relevance of future gender-sensitive early intervention strategies to ameliorate the risk for long-term PTSD.
尽管创伤后应激障碍（PTSD）的患病率存在已知的性别差异，但创伤后早期男性和女性PTSD症状之间关联的潜在差异尚未得到充分描述。本研究利用网络分析来评估创伤后早期男性和女性PTSD症状群之间关联的潜在差异。我们纳入了475名参与者（57.5%自我认定为女性），他们最近（≤2个月）在荷兰经历了人际或机动车潜在创伤事件。过去一个月的PTSD症状用DSM-5的PTSD检查表（PCL-5）进行测量，并根据五节点PTSD症状群烦躁唤醒模型进行综合。我们估计了网络以及中心性指标（强度和可预测性），并在男性（=202）和女性（=273）的子样本中评估了建模网络的稳定性。我们使用网络比较测试（NCT）比较了网络结构。结果在很大程度上证明了男性和女性估计网络结构具有足够的相关性稳定性。对于男性和女性来说，回避症状都是网络中最强且可预测性最高的节点之一。在男性中，焦虑唤醒另外显示出高强度，而再次体验显示出高可预测性。在女性中，再次体验症状同时显示出高强度和高可预测性。NCT显示全球网络结构（=0.08，=0.054）和强度（=0.073，=0.067）无显著差异。事后比较显示，再次体验症状与男性而非女性的认知和情绪负面改变有关（=0.038，=0.005）。结果表明，尽管网络结构的大多数元素在性别之间相似，但在网络结构方面可能存在适度的性别差异。这些结果有助于描述创伤后早期PTSD症状群之间关联的性别差异，这可能为未来性别敏感的早期干预策略改善长期PTSD风险的潜在相关性提供信息。
