Feeling detached: The central role of detachment in a network study of posttraumatic stress symptoms in Public Safety Personnel

Abstract

Background: Due to the nature of their work, Public Safety Personnel (PSP; e.g., firefighters, paramedics, police officers) are frequently exposed to potentially psychological traumatic events (PPTE) and are at increased risk of developing posttraumatic stress symptoms (PTSS) compared to the general population. To date, there are a limited number of published studies that have used the statistical tools of network analysis to examine PTSS in PSP, typically relying on small, homogenous samples. Basic procedures: The current study used a large (n = 5,319) and diverse sample of PSP to estimate a network of PTSS and exploratory graph analysis to assess alternative structures of symptom clustering, compared to tradi- tional latent models. Main findings: The results of the analyses estimated two symptom clusters which differed from most latent models of PTSS. Re-experiencing and avoidance symptoms clustered together, instead of in two clusters. Similarly, hy- perarousal symptoms (hypervigilance, sleep disturbance, startle reflex, concentration difficulties) clustered in a single community instead of two or three clusters in many latent models of PTSS. The symptom of detachment played the most central role in the network and acted as a bridge symptom between numerous clusters of symptoms. The least central symptom was amnesia, which also had the most inconsistent pattern of clustering and bridging. Other bridge symptoms included negative emotions, difficulty concentrating, and reckless behaviour. Principal conclusions: The symptom of detachment played a pervasive role in centrality and bridging in a network of PTSS in PSP. Future research is necessary to identify whether central PTSS differ across populations based on their PPTE type (e.g., combat, assault, rape) or typical environmental factors (e.g., group cohesion in PSP and military).