Symptom structure of complex posttraumatic stress disorder among de facto unattended children in China: A network analysis.

BACKGROUNDS: Complex posttraumatic stress disorder (CPTSD) is closely related to childhood trauma, yet there is a dearth of studies that have explored the symptoms of CPTSD among children in adversity.

OBJECTIVE

The current study aimed to explore the structure of the CPTSD network and to identify central symptoms in a sample of de facto unattended children in China.

METHODS

In total, 244 children and adolescents were included in the analysis, ranging from 9 to 16 years old (11.72 ± 1.64), with 45.49 % girls and 53.67 % boys. The International Trauma Questionnaire (ITQ) was used to assess CPTSD symptoms. We used a regularized partial correlation network to identify which symptoms had a high level of strength centrality or bridge centrality, and a Bayesian network to identify the upstream symptoms.

RESULTS

The results showed that avoidance and emotional numbing had the highest level of strength centrality. Exaggerated startle response and emotional numbing had the highest level of bridge centrality. Last, re-experiencing was identified as upstream in the Bayesian network. Developmental differences are observed in CPTSD symptom centrality compared to adult populations.

CONCLUSIONS

These findings offer insight into key symptoms of CPTSD in vulnerable children and adolescents. We revealed that children and adolescents in adversity who exhibit avoidance, emotional numbing, and re-experiencing should be given more attention.