Centrality of Concentration and Sleep in PTSD and Depressive Symptoms - Networkanalysis of VA Cohort

Or Duek, Rani Hoff, Robert Pietrzak, Ilan Harpaz-Rotem

Research output: Contribution to journalMeeting Abstractpeer-review


In the last few years network approach has gained traction as a way of understanding psychopathology. Most network analysis in PTSD were conducted on a limited number of patients and looked at the network of PTSD alone. This presentation will outline the results of a network approach analysis that was conducted on a large cohort of veterans taken from the Department Veteran Affairs (VA) national database and compared the both PTSD and PTSD with Depression networks.
We analyzed two different networks: Only PTSD symptoms using PCL-4 (N=154,700) and PTSD and Depression symptoms (using PHQ9 for depression; N= 33,800). We used Gaussian Graphical Model that estimates pairwise association parameters between all nodes, and least absolute shrinkage and selection operator (LASSO) in order to control for false positive connections. We compared centrality measures within the networks. Finally, networks were also assessed for stability.
Patients age ranged between 18-94 years, mean age was 41.1 (SD=15.1). PCL-4 scores ranged from 17-85, with mean 57.75 (SD=13.85). Within the PCL-PHQ9 data set, PHQ9 scores ranged between 0-27 with mean score of 14.5 (SD=6.27).
When accounting for depression, we found that the most central symptoms involve sleep and concentration (i.e. dysphoric arousal), in contrast to assessing network of PTSD symptoms alone.
Sleep and concentration require more attention from clinicians, especially when PTSD co-occur with depression. Clinicians should monitor these symptoms and in times, should consider focusing firstly on these before starting trauma focused therapy.
Original languageAmerican English
Pages (from-to)S259-S259
Number of pages1
JournalBiological Psychiatry
Issue number9, Supplement
StatePublished - 1 May 2020
Externally publishedYes


  • Depression
  • Network Analysis
  • PTSD


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