{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:05:46Z","timestamp":1788915946626,"version":"build-2803163510"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:p>Posttraumatic stress disorder (PTSD) is a heterogeneous disorder with no universal symptom presentation. Sex differences in rates of PTSD among military samples are established, such that females are more likely to be diagnosed with PTSD, with severity particularly heightened among females exposed to military sexual assault (MSA). However, limited research has examined the PTSD symptom network structure among MSA survivors and whether it differs by sex. The current study examined global and sex-specific PTSD symptom network structure of PTSD among veterans and service members who were exposed to MSA. Participants were 400 service members\/veterans (54% active duty; 50% male) with a history of MSA exposure recruited through Qualtrics. Participants completed an online survey assessing PTSD symptoms. Network analysis was conducted for the full sample to examine the overall symptom structure. Centrality indices revealed apathy to be the most central symptom, followed by irritability, hyperarousal, hypervigilance, and external avoidance. The Network Comparison Test was utilized to examine potential sex differences in network structure and global strength. There were no sex differences in global structure or network strength. Core symptom network structures of PTSD may be similar for males and females following MSA. Though males and females experience notable differences in PTSD, network structure is not among them. Central symptoms, or the potential treatment targets, could be similar for males and females MSA survivors.<\/jats:p>","DOI":"10.3389\/fpsyg.2024.1452417","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T16:52:11Z","timestamp":1730998331000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Similar PTSD symptom networks observed in male and female survivors of military sexual assault: implications for understanding trauma responses"],"prefix":"10.3389","volume":"15","author":[{"given":"Bingyu","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca K.","family":"Blais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick A.","family":"Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hallie S.","family":"Tannahill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1037\/a0031523","article-title":"The relationship between posttraumatic and depressive symptoms during prolonged exposure with and without cognitive restructuring for the treatment of posttraumatic stress disorder","volume":"81","author":"Aderka","year":"2013","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.janxdis.2016.11.008","article-title":"A network analysis of DSM-5 posttraumatic stress disorder symptoms and correlates in U.S. military veterans","volume":"45","author":"Armour","year":"2017","journal-title":"J. Anxiety Disord."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2091","DOI":"10.3389\/fpsyg.2017.02091","article-title":"Gender differences in posttraumatic stress symptoms after a terrorist attack: a network approach","volume":"8","author":"Birkeland","year":"2017","journal-title":"Front. Psychol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1002\/wps.20375","article-title":"A network theory of mental disorders","volume":"16","author":"Borsboom","year":"2017","journal-title":"World Psychiatry"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1146\/annurev-clinpsy-050212-185608","article-title":"Network analysis: an integrative approach to the structure of psychopathology","volume":"9","author":"Borsboom","year":"2013","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1037\/pas0000254","article-title":"Psychometric properties of the PTSD checklist for diagnostic and statistical manual of mental disorders-fifth edition (PCL-5) in veterans","volume":"28","author":"Bovin","year":"2016","journal-title":"Psychol. Assess."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1037\/ccp0000292","article-title":"Changes in posttraumatic stress disorder (PTSD) and depressive symptoms over the course of prolonged exposure","volume":"86","author":"Brown","year":"2018","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.jad.2024.01.107","article-title":"A dynamical systems analysis of change in PTSD symptoms, depression symptoms, and suicidal ideation among military personnel during treatment for PTSD","volume":"350","author":"Bryan","year":"2024","journal-title":"J. Affect. Disord."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1001\/jamapsychiatry.2016.3470","article-title":"Acute and chronic posttraumatic stress symptoms in the emergence of posttraumatic stress disorder: a network analysis","volume":"74","author":"Bryant","year":"2017","journal-title":"JAMA Psychiatry"},{"key":"ref10","article-title":"PTSD and gender differences in earthquake survivors","volume-title":"Comprehensive guide to post-traumatic stress disorders","author":"Carmassi","year":"2016"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"195","DOI":"10.3758\/s13428-017-0862-1","article-title":"Estimating psychological networks and their accuracy: a tutorial paper","volume":"50","author":"Epskamp","year":"2018","journal-title":"Behav. Res. Methods"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v048.i04","article-title":"Qgraph: network visualizations of relationships in psychometric data. In","volume":"48","author":"Epskamp","year":"2012","journal-title":"J. Stat. Softw."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1037\/abn0000313","article-title":"Further evidence that psychopathology networks have limited replicability and utility: response to Borsboom et al. (2017) and Steinley et al. (2017)","volume":"126","author":"Forbes","year":"2017","journal-title":"J. Abnorm. Psychol."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1080\/00273171.2019.1616526","article-title":"Quantifying the reliability and replicability of psychopathology network characteristics","volume":"56","author":"Forbes","year":"2021","journal-title":"Multivar. Behav. Res."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1177\/1745691617705892","article-title":"Moving forward: challenges and directions for psychopathological network theory and methodology","volume":"12","author":"Fried","year":"2017","journal-title":"Perspect. Psychol. Sci."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00127-016-1319-z","article-title":"Mental disorders as networks of problems: a review of recent insights","volume":"52","author":"Fried","year":"2017","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1486","DOI":"10.1176\/appi.ajp.158.9.1486","article-title":"Gender differences in posttraumatic stress disorder after motor vehicle accidents","volume":"158","author":"Fullerton","year":"2001","journal-title":"Am. J. Psychiatry"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1002\/jts.22470","article-title":"Posttraumatic stress disorder symptom network structures: a comparison between men and women","volume":"33","author":"Gay","year":"2020","journal-title":"J. Trauma. Stress."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1037\/abn0000704","article-title":"Network models of posttraumatic stress disorder: a meta-analysis","volume":"130","author":"Isvoranu","year":"2021","journal-title":"J. Abnorm. Psychol."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1002\/jts.21848","article-title":"National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria","volume":"26","author":"Kilpatrick","year":"2013","journal-title":"J. Trauma. Stress."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2160","DOI":"10.2105\/AJPH.2006.092999","article-title":"The veterans health administration and military sexual trauma","volume":"97","author":"Kimerling","year":"2007","journal-title":"Am. J. Public Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.2105\/AJPH.2009.171793","article-title":"Military-related sexual trauma among veterans health administration patients returning from Afghanistan and Iraq","volume":"100","author":"Kimerling","year":"2010","journal-title":"Am. J. Public Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.jpsychires.2013.11.007","article-title":"Increased risk of alcohol dependency in a cohort of National Guard troops with PTSD: a longitudinal study","volume":"50","author":"Kline","year":"2014","journal-title":"J. Psychiatr. Res."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1007\/s00406-021-01342-z","article-title":"Co-occurrence of severe PTSD, somatic symptoms and dissociation in a large sample of childhood trauma inpatients: a network analysis","volume":"272","author":"Kratzer","year":"2022","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1002\/da.20730","article-title":"Gender differences in depression and PTSD symptoms following combat exposure","volume":"27","author":"Luxton","year":"2010","journal-title":"Depress. Anxiety"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e61","DOI":"10.1016\/j.whi.2011.07.010","article-title":"Gender differences in military sexual trauma and mental health diagnoses among Iraq and Afghanistan veterans with posttraumatic stress disorder","volume":"22","author":"Maguen","year":"2012","journal-title":"Womens Health Issues"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1341276","DOI":"10.1080\/20008198.2017.1341276","article-title":"A Bayesian network analysis of posttraumatic stress disorder symptoms in adults reporting childhood sexual abuse","volume":"8","author":"McNally","year":"2017","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1037\/0033-2909.133.2.183","article-title":"Gender differences in posttraumatic stress disorder","volume":"133","author":"Olff","year":"2007","journal-title":"Psychol. Bull."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.socnet.2010.03.006","article-title":"Node centrality in weighted networks: generalizing degree and shortest paths","volume":"32","author":"Opsahl","year":"2010","journal-title":"Soc. Networks"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.janxdis.2018.03.001","article-title":"The relationship between posttraumatic and depressive symptoms during virtual reality exposure therapy with a cognitive enhancer","volume":"61","author":"Peskin","year":"2019","journal-title":"J. Anxiety Disord."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.copsyc.2016.11.002","article-title":"Gender and PTSD: different pathways to a similar phenotype","volume":"14","author":"Pineles","year":"2017","journal-title":"Curr. Opin. Psychol."},{"key":"ref32","volume-title":"Qualtrics XM: the leading experience management software","year":"2017"},{"key":"ref33","volume-title":"R: A language and environment for statistical computing","year":"2023"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1097\/NMD.0000000000000322","article-title":"A meta-analysis of depressive symptom outcomes in randomized controlled trials for PTSD","volume":"203","author":"Ronconi","year":"2015","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1177\/0886109908314317","article-title":"Gender, distress, and coping in response to terrorism","volume":"23","author":"Sever","year":"2008","journal-title":"Affilia"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1089\/jwh.2016.6080","article-title":"Contrasting gender and combat versus military sexual traumas: psychiatric symptom severity and morbidities in treatment-seeking veterans","volume":"26","author":"Sexton","year":"2017","journal-title":"J Womens Health (Larchmt)"},{"key":"ref001","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1007\/s00127-005-0973-3","article-title":"Is terror gender-blind? Gender differences in reaction to terror events","volume":"40","author":"Solomon","year":"2005","journal-title":"Social Psychiatry and Psychiatric Epidemiology."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e1282","DOI":"10.1093\/milmed\/usad469","article-title":"Using military screening questions to anonymously recruit post-9\/11 era service members and veterans using online survey methods","volume":"189","author":"Tannahill","year":"2023","journal-title":"Mil. Med."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"2262","DOI":"10.1002\/jclp.23162","article-title":"Gender as a moderator of the association of military sexual trauma and posttraumatic stress symptoms","volume":"77","author":"Tannahill","year":"2021","journal-title":"J. Clin. Psychol."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.jad.2020.03.017","article-title":"Gender moderates the association of military sexual trauma and risk for psychological distress among VA-enrolled veterans","volume":"268","author":"Tannahill","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1037\/0033-2909.132.6.959","article-title":"Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research","volume":"132","author":"Tolin","year":"2006","journal-title":"Psychol. Bull."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1037\/met0000476","article-title":"Comparing network structures on three aspects: a permutation test","volume":"28","author":"van Borkulo","year":"2021","journal-title":"Psychol. Methods"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"4","DOI":"10.4103\/0972-6748.98407","article-title":"Gender differences in stress response: role of developmental and biological determinants","volume":"20","author":"Verma","year":"2011","journal-title":"Ind. Psychiatry J."},{"key":"ref43","author":"Weathers","year":"2013"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"102872","DOI":"10.1016\/j.janxdis.2024.102872","article-title":"Longitudinal changes in the PTSD symptom network following trauma-focused treatment in military populations: identifying central symptoms and the role of military sexual trauma","volume":"104","author":"Xu","year":"2024","journal-title":"J. Anxiety Disord."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2024.1452417\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T16:52:14Z","timestamp":1730998334000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2024.1452417\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,7]]},"references-count":45,"alternative-id":["10.3389\/fpsyg.2024.1452417"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2024.1452417","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,7]]},"article-number":"1452417"}}