Abstract：
PTSD has been associated with negative long-term consequences, including social and occupational impairments. Yet, a nuanced understanding of the interplay between PTSD symptoms and distinct domains of impairments on a short-term basis (weeks/ months) at the within-person level remains underexplored. In a large sample (nwave 1 = 1096, nwave 7 = 304) of UK healthcare workers assessed across seven assessment waves during the COVID-19 pandemic (spaced 6 weeks apart), we employed exploratory graphical vector autoregression models (GVAR) models to discern within-person temporal (across time) and contemporaneous (within same time window) dynamics between PTSD symptoms and functional impairment domains. The contemporaneous network highlighted strong co-occurrences between different symptoms and impairments. The temporal network revealed a mutually reinforcing cycle between intrusion and avoidance symptoms. Intrusion symptoms showed the highest out-strength (i.e., most predictive symptom), predicting avoidance symptoms, elevated sense of current threat, and various functional impairments. Avoidance symptoms, elevated after increased levels of intrusions, predicted work impairments that in turn were associated with difficulties in fulfilling other obligations. Our findings underscore the dynamics between perceived threat and intrusions, and the role intrusions may play in predicting a cascade of adverse effects. Targeted interventions aimed at mitigating intrusions may disrupt this negative cycle.
摘要：
创伤后应激障碍与负面的长期后果有关，包括社会和职业损害。然而，在人内水平上,对短期基础上(周/月)PTSD症状与不同损伤领域之间相互作用的细微差别的理解仍未得到充分探索.在COVID-19大流行期间(间隔6周)的七个评估波中评估的英国医护人员的大样本(nwave1=1096，nwave7=304)，我们使用探索性图形向量自回归模型(GVAR)模型来辨别PTSD症状和功能损害领域之间的人内时间(跨时间)和同期(在同一时间窗口内)动态.同时代的网络强调了不同症状和损伤之间的强烈共存。时间网络揭示了入侵和回避症状之间的相辅相成的循环。入侵症状显示出最高的强度(即，最具预测性的症状)，预测回避症状，增强了对当前威胁的意识，和各种功能损害。回避症状，在入侵水平增加后升高，预测的工作减损，这反过来又与履行其他义务的困难有关。我们的发现强调了感知威胁和入侵之间的动态关系，入侵可能在预测一系列不利影响方面发挥的作用。旨在减轻入侵的有针对性的干预措施可能会破坏这种负循环。
