The symptom network structure of postpartum posttraumatic stress disorder among women in Shanghai, China.

Objective: Previous studies have investigated various factors influencing postpartum posttraumatic stress disorder (PP-PTSD). However, limited understanding exists regarding the network structure and interconnections among symptoms of PP-PTSD. This study aims to explore the complex relationship by applying network analysis among postpartum women in Shanghai, China.

Method: A total of 2,552 postpartum women completed the online questionnaire using the 14-item Chinese version of the Perinatal Posttraumatic Stress Disorder Questionnaire. For network analysis, 671 individuals were meticulously chosen from the upper quartile of the Perinatal Posttraumatic Stress Disorder Questionnaire scores, representing the top 25% (cutoff score ≥ 9). Subsequently, Walktrap cluster detection, a method for identifying clusters in networks, was performed on the estimated networks. Additionally, Network Comparison Tests were conducted to examine the variations among individuals based on parity and mode of birth.

Results: The symptoms "distant" (Item 8, felt isolated and disconnected from others) and "numb" (Item 9, had difficulty showing tenderness or love toward others) were found to be the most central and exhibited the strongest correlation (r partial = 0.373). This study identified three symptom clusters: "reexperiencing and avoidance" symptom cluster, "negative alterations in cognitions and mood and arousal" symptom cluster, and "hyper and guilt" symptom cluster.

Conclusions: To mitigate PP-PTSD among postpartum women, effective strategies targeting the central symptoms of "distant" and "numb" are crucial. Prioritizing interventions that address these key symptoms can enhance overall treatment and support effectiveness for individuals with PP-PTSD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).