Evidence map›Paper›PMID 41953089›Full record

ArticleFrontiers in psychiatry2026

Relationship between rumination and symptoms of posttraumatic stress disorder - a cross-sectional network analysis.

Olena Zhabenko, Ziv Ben-Zion, Paul Raffelhüschen, Achim Burrer, Erich Seifritz, Stefan Just, Katrin H Preller, Or Duek, Megan Paterson, Robert H Pietrzak and 3 more

Abstract read
In one paragraph

Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Olena ZhabenkoDepartment of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich (PUK), Zurich, Switzerland.
Ziv Ben-ZionDepartment of Comparative Medicine, Yale University School of Medicine, New Haven, CT, United States.
Paul RaffelhüschenDepartment of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich (PUK), Zurich, Switzerland.
Achim BurrerDepartment of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich (PUK), Zurich, Switzerland.
Erich SeifritzDepartment of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich (PUK), Zurich, Switzerland.
Stefan JustBoehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany.
Katrin H PrellerBoehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany.
Or DuekUnited States Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, Veterans Affairs (VA) Connecticut Health System, West Haven, CT, United States.
Megan PatersonDepartment of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
Robert H PietrzakDepartment of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
Jutta JoormannDepartment of Psychology, Yale University, New Haven, CT, United States.
Tobias R Spiller *Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich (PUK), Zurich, Switzerland.
Ilan Harpaz-Rotem *Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Rumination is associated with the development and maintenance of PTSD. However, significant gaps remain in understanding how specific PTSD symptoms relate to rumination at a granular level, particularly when controlling for common comorbidities like depression and anxiety. This study used multi-level network analysis to examine these relationships in adult survivors of traumatic events. Methods: Six hundred sixty-one adult survivors (median age 35 years, 29 to 45 years, 49.3% females) who had witnessed or experienced a car crash, a violent act, or the killing of someone participated in an online-based study. Participants completed the Posttraumatic Stress Disorder Checklist (PCL-5), the Repetitive Thinking Questionnaire (RTQ-10), the Generalized Anxiety Disorder (GAD-7), and the Patient Health Questionnaire (PHQ-9). Network analysis was conducted at both scale and item levels to examine associations while controlling for depression and anxiety. Results: Network analysis revealed selective associations between rumination and symptoms of PTSD. At the cluster level, rumination was associated with re-experiencing and negative alterations in cognition and mood clusters, but not with avoidance or hyperarousal clusters. At the item level, complex patterns emerged including relevant associations between items assessing intrusive memories and persistent repetitive thoughts. Additionally, a negative association was observed between risk-taking behaviors and future-oriented wishful thinking. Conclusion: Our findings reveal interconnected constructs, which might in part be due to content overlap among the questionnaires used. These findings highlight the importance of precise construct definition and measurement differentiation when investigating trauma-related cognitive processes and establish groundwork for future research examining temporal relationships and clinical applications.

Indexed as

anxietydepressionnetwork analysisPTSDrumination

Identifiers

PMID41953089
PMCPMC13054884

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.