BACKGROUND The latest version of the International Classification of Diseases (ICD-11) proposes a posttraumatic stress disorder (PTSD) diagnosis reduced to its core symptoms within the symptom clusters re-experiencing, avoidance and hyperarousal. Since children and adolescents often show a variety of internalizing and externalizing symptoms in the aftermath of traumatic events, the question arises whether such a conceptualization of the PTSD diagnosis is supported in children and adolescents. Furthermore, although dysfunctional posttraumatic cognitions (PTCs) appear to play an important role in the development and persistence of PTSD in children and adolescents, their function within diagnostic frameworks requires clarification. METHODS We compiled a large international data set of 2,313 children and adolescents aged 6 to 18 years exposed to trauma and calculated a network model including dysfunctional PTCs, PTSD core symptoms and depression symptoms. Central items and relations between constructs were investigated. RESULTS The PTSD re-experiencing symptoms strong or overwhelming emotions and strong physical sensations and the depression symptom difficulty concentrating emerged as most central. Items from the same construct were more strongly connected with each other than with items from the other constructs. Dysfunctional PTCs were not more strongly connected to core PTSD symptoms than to depression symptoms. CONCLUSIONS Our findings provide support that a PTSD diagnosis reduced to its core symptoms could help to disentangle PTSD, depression and dysfunctional PTCs. Using longitudinal data and complementing between-subject with within-subject analyses might provide further insight into the relationship between dysfunctional PTCs, PTSD and depression.

中文翻译：

---

遭受创伤的儿童和青少年创伤后认知功能障碍，创伤后压力和抑郁：网络分析。

背景技术最新版本的《国际疾病分类》（ICD-11）提出了一种创伤后应激障碍（PTSD）诊断，这种诊断已减少到症状群重新体验，避免和过度兴奋的核心症状。由于儿童和青少年在创伤事件发生后常常表现出多种内在化和外在化的症状，因此出现了这样的问题：是否在儿童和青少年中支持这种PTSD诊断的概念化。此外，尽管功能失调的创伤后认知（PTC）在儿童和青少年PTSD的发展和持续中似乎起着重要作用，但仍需要弄清楚它们在诊断框架内的功能。方法我们汇编了一个庞大的国际数据集2，313名6至18岁的儿童和青少年遭受了创伤，并计算了一个网络模型，包括PTCs功能失调，PTSD核心症状和抑郁症状。研究了核心项目和构造之间的关系。结果PTSD重新出现强烈或压倒性情绪的症状以及强烈的身体感觉，抑郁症状难以集中，成为最主要的症状。与来自其他构建体的项目相比，来自同一构建体的项目之间的联系更加紧密。功能失调的PTC与核心PTSD症状的联系并不比抑郁症的症状更紧密。结论我们的发现为PTSD诊断减少到其核心症状提供了支持，可以帮助弄清PTSD，抑郁症和功能失调的PTC。