Cross-Lagged Panel Networks of Distinct Complex Post-Traumatic Stress Disorder Symptom Trajectories Among Young Adults With Adverse Childhood Experiences

Abstract

Background and Objectives: Young adults with a history of adverse childhood experiences (ACEs) may exhibit varying trajectories of complex post-traumatic stress disorder (CPTSD) symptoms over time. Unraveling the patterns of interactions between CPTSD symptoms across distinct trajectories is crucial. This study aimed to investigate the longitudinal relationships, changes, and central symptoms in CPTSD networks over time across distinct CPTSD trajectory groups.

Methods: This longitudinal study followed 1277 university students (47.5% male) who reported ACEs from China through three waves of surveys. ACEs were assessed at baseline, while symptoms of CPTSD were measured at all three time points. Growth mixture modeling (GMM) was used to identify CPTSD symptom trajectories, and cross-lagged panel network (CLPN) analysis estimated the longitudinal relationships among CPTSD symptoms within these trajectories.

Results: Two distinct and consistent CPTSD symptom trajectories were identified: a high-risk group and a resistance group. In the high-risk group, “disturbed relationships” (DRs) and “negative self-concept” (NSC) emerged as the strongest predictors of other symptoms at various time points. In the resilient group, the predictive influence of DR and NSC on other symptoms was attenuated. Instead, “affective dysregulation” (AD) emerged as the central symptom, demonstrating the strong predictive associations with other symptom domains.

Conclusions: These findings reveal directional relationships among symptoms in young adults. Symptoms related to disturbances in self-organization (DSO), identified through centrality indices, are key drivers of symptom network development in different CPTSD trajectories. Targeting these symptoms in interventions for young adults with ACEs may help prevent or reduce CPTSD progression.