Understanding the relationship of trauma memory characteristics to symptoms of PTSD and depression in trauma-exposed children and adolescents: a comprehensive network analysis.

Background

Children and adolescents who experience traumatic events can develop post-traumatic stress disorder (PTSD) and depression. Alterations in autobiographical memory quality have been identified in each of these disorders. However, the complex interplay between PTSD and depressive symptoms and their relationship with traumatic memory characteristics remains unclear. Trauma memory characteristics, including vividness, coherence, and sensory encoding, are central to cognitive models of PTSD, but their role in depression and cross-diagnostic symptom networks remains underexplored.

Methods

We combined ten studies of trauma-exposed children and adolescents (ages 6-18) across diverse cultural contexts, resulting in a final dataset of 1,401 participants (6-18 years) from low - and high-income countries. PTSD symptoms, depressive symptoms, and trauma memory characteristics were harmonised across studies and examined using a regularised partial correlation network (EBICglasso) with Spearman correlations. Centrality analysis identified key symptoms and memory features, while community detection (EGA) assessed whether PTSD, depression, and memory formed distinct constructs. Finally, permutation and bootstrap tests evaluated whether memory characteristics were differentially linked to PTSD symptom clusters.

Results

The estimated network demonstrated satisfactory stability. Physiological reactivity to trauma reminders, flashbacks, and difficulty concentrating emerged as central nodes in the network. Memory features were only linked to PTSD symptoms, not depression symptoms. PTSD symptoms, depressive symptoms, and memory features formed distinct clusters, although some cross-cluster connections were observed. Finally, trauma memory features were not more strongly associated with any PTSD symptom subcluster compared to the others.

Conclusions

Trauma memory qualities appeared as a distinctly separate construct from psychopathology and may not be a strong mechanism underlying comorbidity between PTSD and depression. In children and adolescents experiencing PTSD and depressive symptoms following trauma, physiological reactivity to trauma reminders, flashbacks, and difficulties concentrating could be valuable targets for clinical intervention.