A network analysis of posttraumatic stress, depression, and alcohol use in U.S. veterans: Exploring differences by...

U.S. military service members and veterans are more likely than civilians to have experienced childhood maltreatment and co-occurring posttraumatic stress, depression, and alcohol use. Previous research suggests that childhood maltreatment may influence adult psychopathology through transdiagnostic mechanisms, highlighting the need for analytic techniques that effectively capture this complex relationship. Network analysis is one such technique that shows the connections between symptom-level items within and across disorders. The current study leveraged network analysis to examine the transdiagnostic links between posttraumatic stress, depression, and alcohol use by childhood maltreatment experience in U.S. veterans.

This secondary analysis utilized data from a large, nationally representative survey of U.S. military veterans (N = 3847) to estimate networks of posttraumatic stress, depression, and alcohol use in traumatized veterans who experienced childhood maltreatment (i.e., maltreatment network; n = 1315) and those who did not (i.e., non-maltreatment network; n = 2532).

In both networks, within-construct (e.g., between posttraumatic stress symptoms) connections were stronger than that across-construct (e.g., from posttraumatic stress to depression). Based on indices of centrality (i.e., aggregate connectivity to other items), alcohol use items exhibited the greatest strength. Depression items demonstrated the greatest across-construct influence in both networks. No significant differences were observed in network structure or strength.

These findings suggest that the links between posttraumatic stress, depression, and alcohol use in adulthood may look similar for trauma-exposed U.S. veterans, regardless of childhood maltreatment experience. They further underscore the importance of transdiagnostic approaches to investigate the impact of childhood maltreatment on adult psychopathology in this population.