Network analysis of COVID-19-related PTSD and depressive symptoms among Chinese general population and comorbidity subgroup.

Abstract

Objective: Posttraumatic stress disorder (PTSD) and depressive symptoms are prevalent and highly correlated mental health outcomes of traumatic events, but their comorbidity in the COVID-19 pandemic has not been examined with evidence from Chinese culture. Method: With information from 2,858 Chinese adults, this study used a network analysis to investigate the relationship between PTSD and depressive symptoms along with their symptoms-structure associations. Results: Results indicated similar positive connections among similar cluster symptoms (i.e., positive affect) in both general and comorbidity-reported populations. Self-destructive/reckless behaviors were core symptoms in the general population, and interpersonal difficulties were core symptoms in the comorbidity subgroup. Finally, the very strong communication seen between "arousal and reactivity alterations" and "depressed affect" deserves more attention. Conclusion: Our results indicated interpersonal symptoms can be important targets when intervening or treating PTSD and depressive symptoms related to COVID-19 in the clinical population. Clinical Impact StatementClinicians could target related symptoms in treatment planning at the same time and contribute especially to the treatment of some symptoms that might be difficult to intervene on, such as intrusive thoughts. In addition, the treatment of the most central symptom, self-destructive/reckless behavior in this network, could result in the alleviation of other related symptoms in this network, and particularly prevent the general population from developing comorbidity disorder. Moreover, identifying and intervening the central symptoms and strong bridge nodes are of great importance to prevent comorbidity in the early period.

The similarities and differences of network structures of posttraumatic stress symptoms among Chinese adolescents exposed to three different types of trauma.

“…As for the negative connections, they are explainable as well. The negative connection between nightmares (B2) and blame of self or others (D3) in the disease exposure group is similar to previous findings that nightmares were negatively associated with “I thought my life had been a failure” (Yang et al, 2023). Also, contrary to the positive connection between detachment (D6) and restricted affect (D7), flashbacks (B3) could be a way for people to be exposed to trauma repeatedly, which could arouse negative emotions and release the restricted affect (D7) symptoms (Litz et al, 2000; Shepherd & Wild, 2014).…”

“…Thus, theoretical studies could be conducted in the future to investigate more precise differences between adolescents and adults and the underlying reasons in this field. For the practical section, as in many other network studies (Sun & Zhou, 2023;Yang et al, 2022Yang et al, , 2023, we revealed potential pathways of prevention and intervention for PTSD symptoms among adolescents. In detail, adolescents who experienced severe disease could suffer more serious PTSD symptoms compared with nature and accident exposures.…”

“…In the disease and accident exposure group, negative trauma-related emotions showed strong centrality. Clinicians could adopt mindfulness methods to treat negative emotions, which might result in the alleviation of other related symptoms in this network (Khazaie et al, 2021; Yang et al, 2023). Similarly, for the disaster exposure group, the avoidance of thoughts could be the target symptom for treatment.…”