title: Network approach to the symptom-level association between alcohol use disorder and posttraumatic stress disorder.
abstract: The high prevalence of alcohol use disorder among individuals with a history of trauma and posttraumatic stress disorder is well documented. The current study applied network analysis to map the structure of symptom associations between these disorders.
  
  
  
  Data come from a community sample of 449 Australian adults with a history of trauma and alcohol consumption during the last 12 months. Data analysis consisted of the construction of the comorbidity network of PTSD/AUD symptoms, identification of the bridging symptoms, computation of the centrality measures, and evaluation of the robustness of the results.
  
  
  
  Results highlighted two main symptom clusters, corresponding to two disorders, and that only nine edges connected the two clusters. Bridging symptoms connecting the two clusters were: alcohol use in dangerous situations, physical or mental health problems as a result of alcohol use, loss of interest or reduced social activities, and reckless/self-destructive behaviour.
  
  
  
  Identification of both central symptoms, because of their key role in the constellation and strong associations with majority of symptoms, and bridge symptoms, because of their mediating role between two disorders, has some implications in terms of self-medication and risk-taking/self-regulation theories of comorbidity and provides a number of clinical implications, which warrants further exploration within clinical samples.
authors.affiliation: NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, 2052, Australia. m.afzali@unsw.edu.au.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Afzali
authors.affiliation: NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, 2052, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Sunderland
authors.affiliation: National Institute for Mental Health Research, Australian National University, Canberra, Australia.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Batterham
authors.affiliation: Faulty of Medicine, Office of Medical Education, UNSW, Sydney, Australia.
authors.forename: Natacha
authors.initials: N
authors.lastname: Carragher
authors.affiliation: National Institute for Mental Health Research, Australian National University, Canberra, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Calear
authors.affiliation: NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, 2052, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Slade
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D016000:Cluster Analysis; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016728:Self-Injurious Behavior; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D055815:Young Adult
keywords: Alcohol; Comorbidity; Network; PTSD