PTSD symptom networks during treatment among residents in domestic violence shelters

Little is known about how the interrelationships among posttraumatic stress disorder (PTSD) symptoms change throughout the treatment. We examined changes in PTSD symptoms among women who experienced intimate partner violence and received one of two evidence-based interventions. We conducted a secondary analysis of a completed randomized, double-blind clinical trial, which demonstrated efficacy in reducing PTSD symptoms. We used cross-lagged panel network analysis to identify the influential PTSD symptoms among women who had completed either the Helping to Overcome PTSD through Empowerment or an adapted version of person-centered therapy. We examined if a symptom's expected influence, a metric of interconnectedness, would predict overall PTSD symptom reductions at baseline, postshelter, posttreatment, and 6- and 12-months posttreatment. Women who showed more significant decreases in feeling upset and avoidance also demonstrated greater decreases in their overall PTSD symptoms at postshelter, posttreatment, and 6 and 12 months posttreatment. Findings indicate that changes in symptoms with high centrality result in larger PTSD network changes observed at both adjacent and future time points. Identifying and targeting symptoms with influential associations produce therapeutic cascades, resulting in symptom reductions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).