Unraveling the Link Between Complex Post-traumatic Stress Symptoms and Addictive Behaviors in Adolescents: A Network Analysis

Adolescence is marked by increased susceptibility to trauma-related disorders and substance and behavioral addictions (SBAs). Complex post-traumatic stress disorder (cPTSD) is a newly recognized condition characterized by specific features in addition to those of classic PTSD and is often associated with SBAs. This study adopted a psychopathology network approach to explore which post-traumatic symptoms were explicitly associated with SBAs in a sample of late adolescents. We hypothesized that cPTSD symptoms would be particularly relevant to explain the comorbidity between PTSD and SBAs. A sample of 1010 late adolescents provided measures of post-traumatic symptomatology, cannabis and alcohol abuse, problematic internet use, and gambling. We estimated the network structure of PTSD/cPTSD symptoms and SBAs and assessed their bridge centrality indices. The results suggest that the SBAs had the highest bridge connections with the cPTSD dimension of affective dysregulation, which reported the highest centrality indices. Problematic internet use was the most central cluster of addictive behaviors among SBAs. Therefore, adolescents struggling with affective dysregulation may look for alternative ways to suppress their intense emotions, and SBAs may be sought as a maladaptive coping mechanism. These findings should prompt further research on affective dysregulation as a therapeutic target among adolescents.