Network analysis of posttraumatic stress disorder and posttraumatic growth among patients with an intestinal stoma

Patients with colorectal cancer and an intestinal stoma often experience a complex psychological state where posttraumatic stress disorder (PTSD) coexists with posttraumatic growth (PTG). This study aimed to explore the interplay between PTSD and PTG symptoms in patients with an intestinal stoma to better understand their relationships.

This cross-sectional study was conducted between January 2026 and March 2026, involving patients from three tertiary hospitals in Beijing, Liaoning, and Jilin provinces in China. Data were collected using a sociodemographic questionnaire, the PTG Inventory, and the PTSD Checklist for DSM-5. Network analysis was employed to identify central symptoms and potential bridge symptoms. Model stability and accuracy were assessed through bootstrap resampling.

Data from 416 participants were analyzed. The PTSD-PTG network identified the Posttraumatic Stress Disorder Checklist (PCL)10 ("Blaming yourself or someone else for the stressful experience or what happened after it") and the Posttraumatic Growth Inventory (PTGI) 5 ("A better understanding of spiritual matters") as the most central symptoms. Potential bridge symptoms linking PTSD and PTG included PCL20 ("Trouble falling or staying asleep") and PTGI1 ("My priorities about what is important in life"). The network model demonstrated acceptable stability and accuracy, although bridge expected influence estimates should be interpreted cautiously.

This study identified potentially important PTSD and PTG symptoms and their interactions in patients with an intestinal stoma. Central and bridge symptoms may provide preliminary targets for clinical screening and individualized interventions to support both trauma-related distress and psychological growth. Longitudinal studies are needed to confirm these findings.