Uncovering the dynamics and causality of PTSD symptoms in firefighters: Insights from cross-lagged panel network analyses

Zhongying Wu; Bin Liu; Qiannan Jia; Yuting Feng; Zhujing Ma; Huiling Yuan; Yidi Wang; Yinchuan Jin; Lei Song; Mengze Li; Hongyi Chen; Meng Wei; Lei Ren; Qun Yang

doi:10.1016/j.jpsychires.2024.12.028

Uncovering the dynamics and causality of PTSD symptoms in firefighters: Insights from cross-lagged panel network analyses

J Psychiatr Res. 2024 Dec 25:181:673-680. doi: 10.1016/j.jpsychires.2024.12.028. Online ahead of print.

Authors

Zhongying Wu¹, Bin Liu², Qiannan Jia³, Yuting Feng⁴, Zhujing Ma⁵, Huiling Yuan⁶, Yidi Wang⁷, Yinchuan Jin⁸, Lei Song⁹, Mengze Li¹⁰, Hongyi Chen¹¹, Meng Wei¹², Lei Ren¹³, Qun Yang¹⁴

Affiliations

¹ Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China. Electronic address: [email protected].
² Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China. Electronic address: [email protected].
³ Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China. Electronic address: [email protected].
⁴ Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China. Electronic address: [email protected].
⁵ Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China. Electronic address: [email protected].
⁶ Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China; Department of Psychiatry, Xi'an International Medical Center Hospital, Xi'an, 710100, China. Electronic address: [email protected].
⁷ School of Humanities and Social Science, Xi'an Jiaotong University, Xi'an, 710049, China. Electronic address: [email protected].
⁸ Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China. Electronic address: [email protected].
⁹ Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China. Electronic address: [email protected].
¹⁰ Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China. Electronic address: [email protected].
¹¹ Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China. Electronic address: [email protected].
¹² Shaanxi Fire and Rescue Brigade, Xi'an, 710016, China. Electronic address: [email protected].
¹³ Military Psychology Section, Logistics University of PAP, Tianjin, 300309, China; Military Mental Health Services & Research Center, Tianjin, 300309, China. Electronic address: [email protected].
¹⁴ Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China. Electronic address: [email protected].

PMID: 39746227
DOI: 10.1016/j.jpsychires.2024.12.028

Abstract

Firefighters have a greater prevalence of posttraumatic stress disorder (PTSD) because of their greater risk of exposure to traumatic events. Network analysis offers novel perspectives for understanding PTSD. However, most previous network analysis studies were cross-sectional and failed to reveal the dynamics and causality of PTSD symptoms. Therefore, this study aimed to elucidate the longitudinal development of and causal relationships among PTSD symptoms in firefighters. Two survey waves were conducted among 637 Chinese male firefighters: in April 2021 (baseline) and March 2023 (follow-up). We constructed two cross-sectional networks and one longitudinal cross-lagged panel network (CLPN) of PTSD symptoms. By comparing the two cross-sectional networks, we found that the central symptoms of PTSD changed over time, with central symptoms scattered across different dimensions at baseline and focused on the avoidance dimension at follow-up. The CLPN revealed causal relationships among PTSD symptoms and showed that irritability and nightmares significantly predicted other PTSD symptoms from baseline to follow-up. In summary, our study fills a gap in the longitudinal development of and causal relationships among PTSD symptoms in firefighters and provides potential targets for subsequent prevention and intervention.

Keywords: Cross-lagged panel network; Firefighters; Network analysis; Posttraumatic stress disorder.