What is it about?
This study examined how symptoms of post-traumatic stress, anxiety, and depression are connected among trauma-exposed youth in El Salvador. Many young people in El Salvador experience violence, community insecurity, and other stressful or traumatic events, which can increase the risk for mental health difficulties. Rather than viewing mental health conditions as completely separate disorders, this study used a network analysis approach to understand how specific symptoms influence and reinforce one another. The study included 1,191 Salvadoran youth between the ages of 8 and 18 who had experienced at least one traumatic event. Researchers found that symptoms of PTSD, anxiety, and depression formed interconnected clusters, with some symptoms playing especially important roles within the network. Symptoms such as excessive worry, feelings of worthlessness, sleep problems, concentration difficulties, negative emotions, and risky behavior were among the most central and influential symptoms. These findings suggest that emotional distress in trauma-exposed youth may not come from one single disorder, but from multiple symptoms interacting together over time. Understanding these symptom patterns may help clinicians and schools better identify youth who are struggling and provide more targeted mental health support.
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Why is it important?
This study is important because very little research has examined trauma-related mental health among youth in El Salvador or other Latin American countries using modern symptom-based approaches. Most traditional mental health models treat PTSD, anxiety, and depression as separate diagnoses, but this research shows that symptoms across these conditions are deeply interconnected. The findings highlight the value of transdiagnostic approaches, which focus on treating shared symptoms across disorders rather than addressing each diagnosis separately. For example, targeting sleep problems, worry, negative emotions, or feelings of worthlessness may help reduce broader mental health difficulties across multiple conditions. This work is also timely because youth in many low- and middle-income countries continue to face high levels of violence, adversity, and limited access to mental health services. By identifying the symptoms most strongly connected to psychological distress, this study can help inform more efficient screening tools, culturally responsive interventions, and school-based mental health programs for trauma-exposed youth in Latin America and other under-resourced settings.
Perspectives
One of the most meaningful aspects of this study was contributing to research focused on Salvadoran youth, a population that is often underrepresented in global mental health research despite facing significant exposure to violence and adversity. We wanted to move beyond simply identifying diagnoses and instead better understand how young people actually experience emotional distress in their daily lives. Using network analysis allowed us to see how symptoms connect and potentially reinforce one another, which felt especially important for understanding trauma-related mental health in a more nuanced and human-centered way. It was striking to see symptoms like worry, worthlessness, sleep difficulties, and concentration problems emerge as central across different forms of distress. These findings reinforce the importance of addressing both trauma-specific symptoms and broader emotional suffering when working with youth exposed to adversity. We hope this work contributes to expanding culturally informed and accessible mental health services for youth in El Salvador and across Latin America. We also hope it encourages researchers and clinicians to think more flexibly about mental health by focusing not only on diagnoses, but also on the relationships between symptoms and the broader social conditions shaping young people’s well-being.
Dr. Alejandro L. Vázquez
University of Tennessee Knoxville
Read the Original
This page is a summary of: Understanding the network structure of post-traumatic stress, anxiety, and depression symptoms in a sample of trauma-exposed Salvadoran youths., Traumatology An International Journal, April 2026, American Psychological Association (APA),
DOI: 10.1037/trm0000657.
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