Network approach to the symptom-level association between alcohol use disorder and posttraumatic stress disorder

  • Mohammad H. AfzaliEmail author
  • Matthew Sunderland
  • Philip J. Batterham
  • Natacha Carragher
  • Alison Calear
  • Tim Slade
Original Paper



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.


Network Comorbidity Alcohol PTSD 


Compliance with ethical standards

Ethics statement

Data were collected using a computerized testing; the statutory body responsible for conducting such surveys provided ethical protocols that include written informed consent.

Conflict of interest

The authors have not transmitted any conflict of interest.

Role of funding source

This project was funded by the Endeavour research fellowship granted by department of education and training—Australian Government. The sponsor had no role in study design, data collection, analysis, interpretation of results, report writing, or manuscript submission.

Supplementary material

127_2016_1331_MOESM1_ESM.docx (149 kb)
Supplementary material 1 (DOCX 148 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Mohammad H. Afzali
    • 1
    Email author
  • Matthew Sunderland
    • 1
  • Philip J. Batterham
    • 2
  • Natacha Carragher
    • 3
  • Alison Calear
    • 2
  • Tim Slade
    • 1
  1. 1.NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research CentreUNSW AustraliaSydneyAustralia
  2. 2.National Institute for Mental Health ResearchAustralian National UniversityCanberraAustralia
  3. 3.Faulty of MedicineOffice of Medical Education, UNSWSydneyAustralia

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