Mohammadi Zahra, Dehghani Mahmood, Lavasani Fahimeh Fathali, Farahani Hojjatollah, Ashouri Ahmad, Omidbakhsh Zahra
Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, No. 1, Shahid Mansouri St., Niayesh St., Sattar Khan St, Tehran, 1445613111, Iran.
Department of Psychology, Tarbiat Modares University, Tehran, Iran.
BMC Psychiatry. 2025 Mar 4;25(1):200. doi: 10.1186/s12888-024-06444-1.
The 11th revision of the World Health Organization's International Classification of Diseases (ICD-11) introduces a new disorder called complex posttraumatic stress disorder. This disorder is heterogeneous, and identifying its core symptoms is important for understanding its different aspects. The network approach to psychopathology allows for examining the structure of Complex PTSD at a symptom level, which helps in analyzing direct interactions between symptoms. This study aimed to explore the symptom structure of complex PTSD and identify critical symptoms in the treatment-seeking population in Iran.
Participants consisted of 463 people referred to comprehensive health centers in Tehran from September to December 2023 with psychopathological syndromes who had a history of trauma at different developmental stages. Complex PTSD symptoms were assessed using the International Trauma Questionnaire (ITQ) and International Measurement of Exposure to Traumatic Event checklist. Network analysis was applied to identify the most central symptoms (nodes) and associations between symptoms (edges) by the graphical LASSO algorithm and the EBCglasso method for network estimation.
The result showed that the network of estimated symptoms for Complex PTSD in Iranian culture was highly accurate and stable. The most central symptoms in this network were feelings of failure and worthlessness. Additionally, "long-term upset" was identified as the connection between PTSD symptoms and DSO.
The study determined that feelings of failure and worthlessness are the most central symptoms in the Complex PTSD network. It was suggested that these symptoms should be given priority in theoretical and treatment models of Complex PTSD.
世界卫生组织《国际疾病分类》（ICD - 11）的第11次修订引入了一种名为复杂性创伤后应激障碍的新疾病。这种疾病具有异质性，识别其核心症状对于理解其不同方面很重要。精神病理学的网络方法允许在症状层面检查复杂性创伤后应激障碍的结构，这有助于分析症状之间的直接相互作用。本研究旨在探讨伊朗寻求治疗人群中复杂性创伤后应激障碍的症状结构，并识别关键症状。
参与者包括2023年9月至12月转诊至德黑兰综合健康中心、患有精神病理综合征且在不同发育阶段有创伤史的463人。使用国际创伤问卷（ITQ）和创伤事件暴露国际测量清单评估复杂性创伤后应激障碍症状。应用网络分析，通过图形套索算法和用于网络估计的EBCglasso方法识别最核心的症状（节点）和症状之间的关联（边）。
结果表明，伊朗文化中复杂性创伤后应激障碍估计症状的网络高度准确且稳定。该网络中最核心的症状是失败感和无价值感。此外，“长期心烦意乱”被确定为创伤后应激障碍症状与功能失调性态度之间的联系。
该研究确定失败感和无价值感是复杂性创伤后应激障碍网络中最核心的症状。建议在复杂性创伤后应激障碍的理论和治疗模型中优先考虑这些症状。
