TY - JOUR
T1 - Mapping the Pathways Between Posttraumatic Stress Disorder, Depression, and Alcohol and Cannabis Use
T2 - A Network Analysis
AU - Williamson, Rachel E.
AU - Macia, Kathryn S.
AU - Burton, Joshua
AU - Wickham, Robert E.
N1 - Publisher Copyright:
© 2024 Taylor & Francis Group, LLC.
PY - 2024
Y1 - 2024
N2 - Objective: The present study examines the network structure and, using Bayesian network analysis, estimates the directional pathways among symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and levels of alcohol and cannabis use. Method: A sample of 1471 adults in the United States, who reported at least one potentially traumatic event, completed the PTSD Checklist (PCL-5), Patient Health Questionnaire (PHQ-9), and the Alcohol/Cannabis Use Disorders Identification Test (AUDIT/CUDIT). A regularized partial correlation network provided estimates of symptoms clusters and connections. Directional pathways within the network were then estimated using a directed acyclic graph (DAG). Results: Symptoms clustered in theoretically consistent ways. Risky behavior demonstrated the highest strength centrality and bridge strength. Neither alcohol nor cannabis use appeared central in the network, and DAG results suggested that MDD and PTSD symptoms are more likely to lead to substance use than the other way around. Conclusions: Results suggest that cannabis use is largely connected to alcohol use. Consistent with prior research, risky behavior appeared to be the primary bridge between substance use and PTSD. The direction of associations between substance use and psychological symptoms requires further attention.
AB - Objective: The present study examines the network structure and, using Bayesian network analysis, estimates the directional pathways among symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and levels of alcohol and cannabis use. Method: A sample of 1471 adults in the United States, who reported at least one potentially traumatic event, completed the PTSD Checklist (PCL-5), Patient Health Questionnaire (PHQ-9), and the Alcohol/Cannabis Use Disorders Identification Test (AUDIT/CUDIT). A regularized partial correlation network provided estimates of symptoms clusters and connections. Directional pathways within the network were then estimated using a directed acyclic graph (DAG). Results: Symptoms clustered in theoretically consistent ways. Risky behavior demonstrated the highest strength centrality and bridge strength. Neither alcohol nor cannabis use appeared central in the network, and DAG results suggested that MDD and PTSD symptoms are more likely to lead to substance use than the other way around. Conclusions: Results suggest that cannabis use is largely connected to alcohol use. Consistent with prior research, risky behavior appeared to be the primary bridge between substance use and PTSD. The direction of associations between substance use and psychological symptoms requires further attention.
KW - Alcohol use
KW - cannabis use
KW - depression
KW - directed acyclic graph
KW - network analysis
KW - PTSD
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U2 - 10.1080/15504263.2024.2330620
DO - 10.1080/15504263.2024.2330620
M3 - Article
C2 - 38555875
AN - SCOPUS:85189967215
SN - 1550-4263
VL - 20
SP - 318
EP - 326
JO - Journal of Dual Diagnosis
JF - Journal of Dual Diagnosis
IS - 4
ER -