The Inter-Connectedness of Post-Traumatic Stress Disorder (PTSD) Symptomatology Across the Lifespan

PTSD is defined by a core of inter-connected symptom clusters. It is currently unclear whether this pattern of interconnections remains stable across the lifespan or differs across key developmental periods. Synthesising seven international trauma-exposed samples (N=5,470), we compared network interrelationships among core self-reported and/or caregiver-reported PTSD symptom clusters (re-experiencing, avoidance and arousal) in preschoolers, school-aged children, adolescents, and adults. For self-report from school-age to adulthood, within-cluster connectivity (associations among symptoms within the same cluster) was consistently stronger than between-cluster connectivity (associations among symptoms from different clusters) across all age groups. This was especially true for the re-experiencing symptom cluster. These inter-relationships appeared stable across with lifecourse with no significant age-related differences. In contrast, caregiver reports from preschool to adolescence, showed stronger within-cluster connectivity among arousal symptoms but these only emerged in school-aged children and adolescents. Longitudinal analyses across approximately the first year post-trauma of self-report symptoms indicated that adults overall symptom connectivity increased over time, whereas school-aged childrens and adolescents networks became sparser. These findings suggest that while PTSD network architecture is broadly stable across different age groups, reporter discrepancies and temporal dynamics warrant close attention, especially with regards to less visible, internalised symptoms such as re-experiencing.