{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T09:37:33Z","timestamp":1758188253905,"version":"3.44.0"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"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. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Stroke patients have a high incidence of Post-traumatic stress disorder (PTSD). Previous studies on PTSD in stroke patients mainly focus on the risk factors and possible harms caused by PTSD and use the overall score to explain the severity of PTSD. The interconnections and effects of symptoms are ignored. Network analysis is a statistical method that can discover and visualize complex relationships between multiple variables. The purpose of this study was to identify the central and core symptoms in the symptom network of PTSD in stroke patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>315 patients diagnosed with cerebral apoplexy were selected as the study objects. Symptoms of PTSD were assessed using the Event Impact Scale (IES-R). The graph Gaussian model is used to estimate the network model. To clarify the network relationship and core symptoms of PTSD in stroke patients. The network\u2019s stability and accuracy are tested using the discard example method and non-parametric bootstrap method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>The network analysis found that A11 (I tried not to think about it) has the most substantial relationship with I3 (Other things kept making me think about it). I6 (I thought about it when I didn\u2019t mean to) has the most substantial relationship with I9 (Pictures about it popped into my mind). \u201cI was jumpy and easily startled\u201d(H10) is the core symptom of PTSD in stroke patients. The network structure is suitable for stability and accuracy tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is possible to reduce the severity of PTSD in stroke patients and promote their personal growth by taking timely intervention measures according to the identified central symptoms of PTSD.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1663366","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T05:31:27Z","timestamp":1758173487000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Network analysis of post-traumatic stress disorder symptoms in stroke patients"],"prefix":"10.3389","volume":"16","author":[{"given":"Yingying","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanchun","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenmei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1649503","article-title":"Global burden of stroke","volume":"38","author":"Katan","year":"2018","journal-title":"Semin Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61953-4","article-title":"Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010","volume":"383","author":"Feigin","year":"2014","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000165928.19135.35","article-title":"Frequency of depression after stroke: a systematic review of observational studies","volume":"36","author":"Hackett","year":"2005","journal-title":"Stroke."},{"key":"B4","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1192\/bjp.bp.111.107664","article-title":"Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis","volume":"202","author":"Ayerbe","year":"2013","journal-title":"Br J Psychiatry"},{"key":"B5","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1080\/13548500601162747","article-title":"Psychological correlates of PTSD symptoms following stroke","volume":"12","author":"Merriman","year":"2007","journal-title":"Psychol Health Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3761\/j.issn.0254-1769.2023.03.003","article-title":"Application effect of multi module rehabilitation nursing model in intelligent follow-up of stroke patients","volume":"58","author":"Duan","year":"2023","journal-title":"Chin J Nurs."},{"key":"B7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/978-3-658-38807-2_2","article-title":"Trauma and posttraumatic stress disorder (PTSD)\u2014Definition, classification, epidemiology and history","volume-title":"Trauma and trauma consequence disorder: in media, management and public","author":"Pausch","year":"2022"},{"key":"B8","doi-asserted-by":"publisher","first-page":"R147","DOI":"10.1186\/cc5070","article-title":"Social support during intensive care unit stay might improve mental impairment and consequently health-related quality of life in survivors of severe acute respiratory distress syndrome","volume":"10","author":"Deja","year":"2006","journal-title":"Crit Care"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.655209","article-title":"Posttraumatic stress disorder and adherence to medications in survivors of strokes and transient ischemic attacks","volume":"43","author":"Kronish","year":"2012","journal-title":"Stroke."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.359285","article-title":"Post-traumatic stress disorder after stroke: A systematic review","volume":"70","author":"Tang","year":"2022","journal-title":"Neurol India."},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23271","article-title":"Stroke hospitalizations, posttraumatic stress disorder, and 9\/11-related dust exposure: Results from the World Trade Center Health Registry","volume":"64","author":"Yu","year":"2021","journal-title":"Am J Ind Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.47391\/jpma.1260","article-title":"Post-traumatic stress disorder, cognitive function and adjustment problems in women burn survivors: A multi-center study","volume":"70","author":"Bano","year":"2020","journal-title":"J Pak Med Assoc"},{"key":"B13","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.janxdis.2010.08.004","article-title":"Assessment of cognitive functions in individuals with post-traumatic symptoms after work-related accidents","volume":"25","author":"Buodo","year":"2011","journal-title":"J Anxiety Disord"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1398003","DOI":"10.1080\/20008198.2017.1398003","article-title":"PTSD symptomics: network analyses in the field of psychotraumatology","volume":"8","author":"Armour","year":"2017","journal-title":"Eur J Psychotraumatol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.jad.2022.06.051","article-title":"Network analysis of comorbid depression and anxiety and their associations with quality of life among clinicians in public hospitals during the late stage of the COVID-19 pandemic in China","volume":"314","author":"Jin","year":"2022","journal-title":"J Affect Disord"},{"key":"B16","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":"B17","doi-asserted-by":"publisher","DOI":"10.1017\/S0140525X17002266","article-title":"Brain disorders? Not really: Why network structures block reductionism in psychopathology research","volume":"42","author":"Borsboom","year":"2018","journal-title":"Behav Brain Sci"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1177\/0844562120927535","article-title":"A cross-sectional exploration of cytokine-symptom networks in breast cancer survivors using network analysis","volume":"53","author":"Henneghan","year":"2021","journal-title":"Can J Nurs Res"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1209936","article-title":"The relationship between alexithymia, depression, anxiety, and stress in elderly with multiple chronic conditions in China: a network analysis","volume":"14","author":"Shang","year":"2023","journal-title":"Front Psychiatry"},{"key":"B20","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":"B21","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.brat.2016.06.006","article-title":"Can network analysis transform psychopathology","volume":"86","author":"Mcnally","year":"2016","journal-title":"Behav Res Ther"},{"key":"B22","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1186\/s12888-024-06138-8","article-title":"Network analysis of resilience, anxiety and depression in clinical nurses","volume":"24","author":"Zhou","year":"2024","journal-title":"BMC Psychiatry"},{"key":"B23","article-title":"The impact of event scale\u2014revised","volume-title":"Assessing psychological trauma and PTSD","author":"Weiss","year":"1997"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-197905000-00004","article-title":"Impact of Event Scale: a measure of subjective stress","volume":"41","author":"Horowitz","year":"1979","journal-title":"Psychosom Med"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1005-3611.2007.01.006","article-title":"Reliability and validity of chinese version of the impact of event scale- revised","volume":"1","author":"Guosu-","year":"2007","journal-title":"Chin J Clin Psychol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.722093","article-title":"Impact of COVID-19 on mental health of chinese residents in its initial stage","volume":"12","author":"Yang","year":"2021","journal-title":"Front Psychol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1007\/s12144-020-01109-0","article-title":"The psychological impact of COVID-19 outbreak on medical staff and the general public","volume":"41","author":"Chen","year":"2022","journal-title":"Curr Psychol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1146\/annurev-clinpsy-081219-092850","article-title":"Network analysis of psychopathology: controversies and challenges","volume":"17","author":"Mcnally","year":"2021","journal-title":"Annu Rev Clin Psychol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2019.1614898","article-title":"Bridge centrality: A network approach to understanding comorbidity","volume":"56","author":"Jones","year":"2021","journal-title":"Multivariate Behav Res"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1177\/0145445517747287","article-title":"The impact of experiential avoidance and event centrality in trauma-related rumination and posttraumatic stress","volume":"42","author":"Bishop","year":"2018","journal-title":"Behav Modif."},{"key":"B31","article-title":"Peer relationships and self-esteem among children who have been maltreated","volume":"69","author":"Bolger","year":"1998","journal-title":"Child Dev"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-8624.2006.00894.x","article-title":"Longitudinal trajectories of self-system processes and depressive symptoms among maltreated and nonmaltreated children","volume":"77","author":"Kim","year":"2006","journal-title":"Child Dev"},{"key":"B33","article-title":"Effects of attachment and ruminant thinking on post traumatic stress disorder and drug compliance in stroke patients","author":"Kp","year":"2020"},{"key":"B34","doi-asserted-by":"publisher","first-page":"113312","DOI":"10.1016\/j.bbr.2021.113312","article-title":"Altered resting-state functional connectivity of the default mode and central executive networks following cognitive processing therapy for PTSD","volume":"409","author":"Vuper","year":"2021","journal-title":"Behav Brain Res"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2016.07.004","article-title":"MDMA and PTSD treatment: \u201cPTSD: From novel pathophysiology to innovative therapeutics","volume":"649","author":"Sessa","year":"2017","journal-title":"Neurosci Lett"},{"key":"B36","doi-asserted-by":"publisher","first-page":"108401","DOI":"10.1016\/j.biopsycho.2022.108401","article-title":"Vigilance: A novel conditioned fear response that resists extinction","volume":"174","author":"Armstrong","year":"2022","journal-title":"Biol Psychol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-020-00303-9","article-title":"Individuals with the post-traumatic stress disorder process emotions in subcortical regions irrespective of cognitive engagement: a meta-analysis of cognitive and emotional interface","volume":"15","author":"Lee","year":"2021","journal-title":"Brain Imaging Behav"},{"key":"B38","doi-asserted-by":"publisher","first-page":"111172","DOI":"10.1016\/j.pscychresns.2020.111172","article-title":"Neural affective mechanisms associated with treatment responsiveness in veterans with PTSD and comorbid alcohol use disorder","volume":"305","author":"Harl\u00e9","year":"2020","journal-title":"Psychiatry Res Neuroimaging."},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.13437\/j.cnki.jcr.2024.07.032","article-title":"Advances in neuroimaging research on pathogenesis and diagnosis of post-traumatic stress disorder","volume":"43","author":"Beining","year":"2024","journal-title":"J Clin Radiol"},{"key":"B40","article-title":"A review of PTSD and current treatment strategies","volume":"118","author":"Schrader","year":"2021","journal-title":"Mo Med"},{"key":"B41","doi-asserted-by":"publisher","first-page":"104734","DOI":"10.1016\/j.chiabu.2020.104734","article-title":"Complex trauma and Trauma-Focused Cognitive-Behavioral Therapy: How do trauma chronicity and PTSD presentation affect treatment outcome","volume":"111","author":"Ross","year":"2021","journal-title":"Child Abuse Negl"},{"key":"B42","doi-asserted-by":"publisher","first-page":"102115","DOI":"10.1016\/j.cpr.2021.102115","article-title":"Exposure therapy for PTSD: A meta-analysis","volume":"91","author":"Mclean","year":"2022","journal-title":"Clin Psychol Rev"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000970","article-title":"The effects of cognitive processing therapy + hypnosis on objective sleep quality in women with posttraumatic stress disorder","volume":"13","author":"Arditte Hall","year":"2021","journal-title":"Psychol Trauma."},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1166(199805)13:5<315::AID-GPS766>3.0.CO;2-P","article-title":"Does post-traumatic stress disorder occur after stroke: a preliminary study","volume":"13","author":"Sembi","year":"1998","journal-title":"Int J Geriatr Psychiatry"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000194210.98757.49","article-title":"Chronic posttraumatic stress symptoms after nonsevere stroke","volume":"66","author":"Bruggimann","year":"2006","journal-title":"Neurology."},{"key":"B46","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.brat.2007.10.006","article-title":"Cross-sectional and prospective associations between cognitive appraisals and posttraumatic stress disorder symptoms following stroke","volume":"46","author":"Field","year":"2008","journal-title":"Behav Res Ther"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2009.03.007","article-title":"Screening for anxiety and depression after stroke: comparison of the hospital anxiety and depression scale and the Montgomery and Asberg depression rating scale","volume":"67","author":"Sagen","year":"2009","journal-title":"J Psychosom Res"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2010.10.002","article-title":"Posttraumatic stress disorder and psychiatric co-morbidity following stroke: the role of alexithymia","volume":"188","author":"Wang","year":"2011","journal-title":"Psychiatry Res"},{"key":"B49","article-title":"Psychological effect and psychological recovery of PTSD","author":"Yue","year":"2003","journal-title":"Chin J Clin Rehabi."},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1002\/da.23112","article-title":"Network analysis of PTSD and depressive symptoms in 158,139 treatment-seeking veterans with PTSD","volume":"38","author":"Duek","year":"2021","journal-title":"Depress Anxiety."},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1096771","article-title":"Post-traumatic stress disorder and depressive symptoms among firefighters: a network analysis","volume":"11","author":"Cheng","year":"2023","journal-title":"Front Public Health"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1663366\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T05:31:50Z","timestamp":1758173510000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1663366\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,18]]},"references-count":51,"alternative-id":["10.3389\/fpsyt.2025.1663366"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2025.1663366","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,18]]},"article-number":"1663366"}}