Changes in network centrality of psychopathology symptoms between the COVID-19 outbreak and after peak

Abstract

The current study investigated the mechanism and changes in psychopathology symptoms throughout the COVID-19 outbreak and after peak. Two studies were conducted separately in China during outbreak and the after peak stages, with 2540 participants were recruited from February 6 to 16, 2020, and 2543 participants were recruited from April 25 to May 5, 2020. The network models were created to explore the relationship between psychopathology symptoms both within and across anxiety and depression, with anxiety measured by the Generalized Anxiety Disorder-7 and depression measured by the Patient Health Questionnaire-9. Symptom network analysis was conducted to evaluate network and bridge centrality, and the network properties were compared between the outbreak and after peak. Noticeably, psychomotor symptoms such as impaired motor skills, restlessness, and inability to relax exhibited high centrality during the outbreak, which still relatively high but showed substantial remission during after peak stage (in terms of strength, betweenness, or bridge centrality). Meanwhile, symptoms of irritability (strength, betweenness, or bridge centrality) and loss of energy (bridge centrality) played an important role in the network after the peak of the pandemic. This study provides novel insights into the changes in central features during the different COVID-19 stages and highlights motor-related symptoms as bridge symptoms, which could activate the connection between anxiety and depression. The results revealed that restrictions on movement were associated with worsen in psychomotor symptoms, indicating that future psychological interventions should target motor-related symptoms as priority.

The network structure of stress-related states, depression, and anxiety symptoms during the COVID-19 lockdown

“…Our findings are consistent with those found by Wang et al (2020) in a study of depression and anxiety symptoms during the outbreak of the pandemic in China except that these authors also found restlessness, psychomotor problems and suicidality also to be central symptoms. Thus, bodily troubles and suicidality appeared to have more influence on other symptoms in China than in Norway.…”

“…Related to COVID-19 pandemic, Wang et al (2020) investigated the MDD and GAD networks among Chinese adults during the COVID-19 outbreak and after peak. At outbreak, the MDD symptoms depressed mood, loss of energy, psychomotor problems and suicidality and the GAD symptoms generalized worry, trouble relaxing and restlessness showed high strength centrality.…”

Excessive Worrying as a Central Feature of Anxiety during the First COVID-19 Lockdown-Phase in Belgium: Insights from a Network Approach

“…Concerning the COVID-19 pandemic, only a few studies have so far applied a network analytic framework to examine the interdependence between different factors assumedly ANXIETY DURING THE COVID-19 LOCKDOWN 6 involved in the psychological responses to the pandemic, and especially regarding the fear of infection or the anxious response to the structural impact of the pandemic (e.g., Jiang et al, 2020;Papini et al, 2020;Taylor et al, 2020). And for the anxiety symptoms reported in the general population during the COVID-19 pandemic, only two studies (i.e., Hoffart et al, 2020;Wang et al, 2020) have, until now, investigated the interrelationships between the distinct hallmark symptoms of GAD as experienced during lockdown through the lens of the network approach. For ease of comparison, both studies (i.e., Hoffart et al, 2020;Wang et al, 2020) relied on the Generalized Anxiety Disorder-7 (GAD-7; Spitzer et al, 2006), one of the most commonly used self-reported screening tools in epidemiological and clinical research for assessing GAD symptoms (e.g., Schalet et al, 2014).…”

“…And for the anxiety symptoms reported in the general population during the COVID-19 pandemic, only two studies (i.e., Hoffart et al, 2020;Wang et al, 2020) have, until now, investigated the interrelationships between the distinct hallmark symptoms of GAD as experienced during lockdown through the lens of the network approach. For ease of comparison, both studies (i.e., Hoffart et al, 2020;Wang et al, 2020) relied on the Generalized Anxiety Disorder-7 (GAD-7; Spitzer et al, 2006), one of the most commonly used self-reported screening tools in epidemiological and clinical research for assessing GAD symptoms (e.g., Schalet et al, 2014). In their study, Wang et al (2020) identified excessive worry, trouble relaxing, and restlessness as the most central nodes in the structure of GAD symptoms among Chinese adults during the early first weeks of the outbreak (i.e., lockdown).…”

“…For ease of comparison, both studies (i.e., Hoffart et al, 2020;Wang et al, 2020) relied on the Generalized Anxiety Disorder-7 (GAD-7; Spitzer et al, 2006), one of the most commonly used self-reported screening tools in epidemiological and clinical research for assessing GAD symptoms (e.g., Schalet et al, 2014). In their study, Wang et al (2020) identified excessive worry, trouble relaxing, and restlessness as the most central nodes in the structure of GAD symptoms among Chinese adults during the early first weeks of the outbreak (i.e., lockdown). Likewise, Hoffart et al (2020) identified excessive worry, uncontrollability of worry, and trouble relaxing (but not restlessness) as the most central nodes among Norwegian adults during the early weeks of the lockdown.…”