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Network approach to the symptom-level association between alcohol use disorder and posttraumatic stress disorder

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Abstract

Purpose

The high prevalence of alcohol use disorder among individuals with a history of trauma and posttraumatic stress disorder is well documented. The current study applied network analysis to map the structure of symptom associations between these disorders.

Methods

Data come from a community sample of 449 Australian adults with a history of trauma and alcohol consumption during the last 12 months. Data analysis consisted of the construction of the comorbidity network of PTSD/AUD symptoms, identification of the bridging symptoms, computation of the centrality measures, and evaluation of the robustness of the results.

Results

Results highlighted two main symptom clusters, corresponding to two disorders, and that only nine edges connected the two clusters. Bridging symptoms connecting the two clusters were: alcohol use in dangerous situations, physical or mental health problems as a result of alcohol use, loss of interest or reduced social activities, and reckless/self-destructive behaviour.

Conclusions

Identification of both central symptoms, because of their key role in the constellation and strong associations with majority of symptoms, and bridge symptoms, because of their mediating role between two disorders, has some implications in terms of self-medication and risk-taking/self-regulation theories of comorbidity and provides a number of clinical implications, which warrants further exploration within clinical samples.

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Author information

Authors and Affiliations

  1. NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, 2052, Australia

    Mohammad H. Afzali, Matthew Sunderland & Tim Slade

  2. National Institute for Mental Health Research, Australian National University, Canberra, Australia

    Philip J. Batterham & Alison Calear

  3. Faulty of Medicine, Office of Medical Education, UNSW, Sydney, Australia

    Natacha Carragher

Authors
  1. Mohammad H. Afzali
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  2. Matthew Sunderland
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  3. Philip J. Batterham
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  4. Natacha Carragher
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  5. Alison Calear
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  6. Tim Slade
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Corresponding author

Correspondence to Mohammad H. Afzali.

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Ethics statement

Data were collected using a computerized testing; the statutory body responsible for conducting such surveys provided ethical protocols that include written informed consent.

Conflict of interest

The authors have not transmitted any conflict of interest.

Role of funding source

This project was funded by the Endeavour research fellowship granted by department of education and training—Australian Government. The sponsor had no role in study design, data collection, analysis, interpretation of results, report writing, or manuscript submission.

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Afzali, M.H., Sunderland, M., Batterham, P.J. et al. Network approach to the symptom-level association between alcohol use disorder and posttraumatic stress disorder. Soc Psychiatry Psychiatr Epidemiol 52, 329–339 (2017). https://doi.org/10.1007/s00127-016-1331-3

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  • DOI: https://doi.org/10.1007/s00127-016-1331-3

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