Changes in the Networks of Complex Posttraumatic Stress Disorder Symptoms Among Chinese College Students With Childhood Trauma

Objective: To advance understanding of the development of complex posttraumatic stress disorder (CPTSD) symptoms longitudinally and facilitate future treatments, the present study investigated changes in the network of CPTSD symptoms among Chinese college students with childhood trauma. Method: A longitudinal study was conducted with college students, following them three times at 3-month intervals. CPTSD symptoms were measured using the International Trauma Questionnaire, and childhood trauma was assessed by the revised Adverse Childhood Experiences Scale. The final sample consisted of 294 participants with childhood trauma at baseline measurement (28.9% were males, M-age = 20.76 years). Comparisons of cross-sectional networks and cross-lagged panel network (CLPN) analysis were performed to characterize the features and changes of interactions among CPTSD symptoms. Results: Sense of failure and isolation were the core symptoms in the cross-sectional networks of CPTSD symptoms. The comparison of cross-sectional networks indicated that the global network strength was stable, and no node's strength centrality and only one edge weight changed significantly from Time 1 (T1) to Time 3 (T3). The findings of the CLPN model reveal that worthlessness, difficulties with intimacy, and flashbacks have the highest out-expected influence. In the T1-T3 network, the strongest edge was from worthlessness to sense of failure. Conclusions: Cross-sectional network analyses and comparisons revealed the characteristics of CPTSD networks at multiple time points, while the CLPN analysis identified the longitudinal dynamics of CPTSD symptoms. These provide insights for designing more targeted intervention plans for college students with childhood trauma.