Title Network analysis of anxiety and depressive symptoms among nursing students during the COVID-19 pandemic*
Authors Bai, Wei
Xi, Hai-Tao
Zhu, Qianqian
Ji, Mengmeng
Zhang, Hongyan
Yang, Bing-Xiang
Cai, Hong
Liu, Rui
Zhao, Yan-Jie
Chen, Li
Ge, Zong-Mei
Wang, Zhiwen
Han, Lin
Chen, Pan
Liu, Shuo
Cheung, Teris
Tang, Yi-Lang
Jackson, Todd
An, Fengrong
Xiang, Yu-Tao
Affiliation Univ Macau, Dept Publ Hlth & Med Adm, Unit Psychiat, Macau, Peoples R China
Univ Macau, Fac Hlth Sci, Inst Translat Med, Macau, Peoples R China
Univ Macau, Ctr Cognit & Brain Sci, Macau, Peoples R China
Univ Macau, Inst Adv Studies Humanities & Social Sci, Macau, Peoples R China
Jilin Univ, Coll Nursing, Jilin, Jilin, Peoples R China
Capital Med Univ, Sch Nursing, Beijing, Peoples R China
Capital Med Univ, Sch Mental Hlth, Natl Clin Res Ctr Mental Disorders, Beijing, Peoples R China
Capital Med Univ, Sch Mental Hlth, Beijing Anding Hosp, Beijing Key Lab Mental Disorders, Beijing, Peoples R China
Capital Med Univ, Sch Mental Hlth, Adv Innovat Ctr Human Brain Protect, Beijing, Peoples R China
Peking Univ, Sch Nursing, Beijing, Peoples R China
Lanzhou Univ, Sch Nursing, Lanzhou, Gansu, Peoples R China
Atlanta VA Med Ctr, Decatur, GA USA
Hong Kong Polytech Univ, Sch Nursing, Hong Kong, Peoples R China
Emory Univ, Dept Psychiat & Behav Sci, Atlanta, GA 30322 USA
Univ Macau, Dept Psychol, Taipa, Macao, Peoples R China
Keywords MENTAL-HEALTH
PREVALENCE
DISORDERS
ANHEDONIA
OUTBREAK
CHINA
Issue Date 1-Nov-2021
Publisher JOURNAL OF AFFECTIVE DISORDERS
Abstract Background: The 2019 coronavirus disease (COVID-19) pandemic has impacted the mental health and wellbeing of medical personnel, including nursing students. Network analysis provides a deeper characterization of symptom-symptom interactions in mental disorders. The aim of this study was to elucidate characteristics of anxiety and depressive symptom networks of Chinese nursing students during the COVID-19 pandemic. Method: A total of 932 nursing students were included. Anxiety and depressive symptom were measured using the seven-item Generalized Anxiety Disorder Scale (GAD-7) and two-item Patient Health Questionnaire (PHQ-2), respectively. Central symptoms and bridge symptoms were identified via centrality indices and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. Results: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood had the highest centrality values. Three bridge symptoms (Depressed mood, Nervousness, and Anhedonia) were also identified. Neither gender nor region of residence was associated with network global strength, distribution of edge weights or individual edge weights. Limitations: Data were collected in a cross-sectional study design, therefore, causal relations and dynamic changes between anxiety and depressive symptoms over time could not be inferred. Generalizability of findings may be limited to Chinese nursing students during a particular phase of the current pandemic. Conclusions: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood constituted central symptoms maintaining the anxiety-depression network structure of Chinese nursing students during the pandemic. Timely, systemic multi-level interventions targeting central symptoms and bridge symptoms may be effective in alleviating co-occurring experiences of anxiety and depression in this population.
URI http://hdl.handle.net/20.500.11897/624209
ISSN 0165-0327
DOI 10.1016/j.jad.2021.07.072
Indexed SCI(E)
SSCI
Appears in Collections: 护理学院

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