[Complex psychological trauma and network analysis: From childhood to adulthood].

Abstract

Complex post-traumatic stress disorder is a recent diagnosis with manifestations that differ from those of post-traumatic stress disorder. Persistent functional impairment is a new dimension specific to complex trauma. Some aspects of this diagnostic category which was adopted by the international classification of diseases eleventh revision are still being studied, for example, its prevalence across the world in many cultural situations where the exposure to traumatic events differ. Network analysis offers a new conceptualization of psychopathology by focusing on interactions between symptoms beyond the usual latent class approach. It makes it possible to statistically validate the international classification of diseases' new diagnostic criteria by differentiating the manifestations of different pathologies such as intense stress exposure pathologies or borderline disorder that share symptoms. It also provides various insights into this disorder and allows us to observe sequences of appearance and evolution depending on age and type of event. While childhood trauma appears to be particularly associated with complex post-traumatic stress disorder, literature mainly highlights the long-term consequences of such childhood events in adulthood. The persistent functional impairment cluster is particularly important within complex trauma networks. This is one of the most important developmental consequences for survivors and reflects a reality perceived by clinicians. This extends to psychotherapy which turns out to be longer and more complex because of the insecurity of the relationship experienced by the traumatized person. Network analysis applied to complex trauma gives an understanding of the dynamics of the relationships between its multitude of symptoms. They can define intervention targets for mental health professionals. And they can enable coordinated multi-professional actions which is an important issue especially in multi-factorial situations such as child protection. This work explores the contributions of network analysis to the understanding of complex post-traumatic stress disorder. For this purpose, we outline the central concepts of complex trauma and its implications. In particular, the impact of recurring traumatic situations of an interpersonal nature on self-construction and the ability to create relationships. We exhibit the fundamental principles of the network approach and compare the contributions of older cross-sectional analyzes with those of longitudinal networks. Then, we provide an overview of the knowledge acquired through the application of network analysis to complex trauma, from childhood to adulthood. Finally, we discuss criticisms of this approach and propose reflections on the future of this statistical analysis method which is growing fast.