BackgroundThe Coronavirus (COVID-19) pandemic resulted in a dramatic increase in the prevalence of anxiety and depression globally. Although the impact on the mental health of young adults was especially strong, its underlying mechanisms remain elusive.Materials and methodsUsing a network approach, the present study investigated the putative pathways between pandemic-related factors and anxiety and depressive symptoms among young adults in South Korea and the U.S. Network analyses were conducted on cross-country data collected during the COVID-19 lockdown period (n = 1,036). Our model included depression symptoms (PHQ-9), generalized anxiety symptoms (GAD-7), and COVID-19-related factors (e.g., COVID-19-related traumatic stress, pandemic concerns, access to medical/mental health services).ResultsThe overall structure of pandemic-to-symptom networks of South Korea and the U.S. were found to be similar. In both countries, COVID-related stress and negative future anticipation (an anxiety symptom) were identified as bridging nodes between pandemic-related factors and psychological distress. In addition, worry-related symptoms (e.g., excessive worry, uncontrollable worry) were identified as key contributors in maintaining the overall pandemic-to-symptom network in both countries.ConclusionThe similar network structures and patterns observed in both countries imply that there may exist a stable relationship between the pandemic and internalizing symptoms above and beyond the sociocultural differences. The current findings provide new insights into the common potential pathway between the pandemic and internalizing symptoms in South Korea and in the U.S. and inform policymakers and mental health professionals of potential intervention targets to alleviate internalizing symptoms.

Background. COVID-19 resulted in dramatic increases in anxiety and depression. Using network analysis, we sought to investigate how COVID-19-related factors are associated with internalizing symptoms in South Korea and the United States. Methods. During the COVID-19 lockdown period, 1008 college students (South Korea, n = 660; U.S., n = 348) responded to an online survey. Our model included depression (PHQ-9), generalized anxiety (GAD-7), and COVID-19-related factors (e.g., COVID-19-related traumatic stress, pandemic concerns).Results. A mixed graphical model revealed that COVID-19-related traumatic stress was specifically linked to “Negative future anticipation” in the anxiety clusters in both countries. “Uncontrollable worry” and “Excessive worry” symptoms showed the highest centrality and predictability value in both South Korea and the U.S., suggesting that worry-related symptoms were the most influential in maintaining the whole (pandemic to internalizing symptoms) network in both countries. A network comparison test revealed no significant differences in network structure and overall connectivity between the networks of the two countries. Conclusions. These results suggest new insights into the common potential pathway between the pandemic and internalizing symptoms in South Korea and the U.S. In addition, our findings imply that targeting worry-related symptoms could maximize the control of the pandemic-to-symptom network.