A network analysis of posttraumatic stress symptoms and quality of relationship with deceased in COVID-19 bereaved adults

Psychol Trauma. 2023 Sep 7. doi: 10.1037/tra0001585. Online ahead of print.

Abstract

Objective: Network analyses showed that the posttraumatic stress disorder (PTSD) symptom structures may vary across traumatic events and types of survivors. However, the structure of PTSD symptoms in COVID-19 bereavement remains unknown. This study aimed to depict the structure of the PTSD symptom network and illuminate how the quality of the predeath relationship between the bereaved and the deceased links to the PTSD symptom network.

Method: Using self-reported data from 408 COVID-19 bereaved adults (225 male and 183 female) collected within 9-month postbereavement, we constructed two graphical lasso networks of PTSD symptoms.

Results: Symptoms with the highest centrality were exaggerated startle, negative emotional states, and reckless/self-destructive behavior, with exaggerated startle having relatively low predictability. The strongest connections were found between exaggerated starkness and detachment, and between psychological cue response and thoughts of avoidance. Moreover, closeness to and conflict with the deceased were linked to the PTSD symptom network through nightmares and physiological cue reactivity, respectively.

Conclusions: This study extends our understanding of what PTSD is for people who are bereaved due to the COVID-19 pandemic by unveiling the structure of the PTSD symptom network. It also helps to distinguish the symptom-level links between quality of relationship with deceased and PTSD among the bereaved. (PsycInfo Database Record (c) 2023 APA, all rights reserved).