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Zou J, Bian B, Li M, Liu G. The interrelationship between sleep disturbance symptoms and aggression before and after the campus closure of the COVID-19 pandemic: insight from a cross-lagged panel network model. Front Public Health 2024; 12:1357018. [PMID: 38577287 PMCID: PMC10991807 DOI: 10.3389/fpubh.2024.1357018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/20/2024] [Indexed: 04/06/2024] Open
Abstract
Background The COVID-19 pandemic is detrimental to sleep quality and increases aggression among college students. Nevertheless, relevant studies were rare. Hence, we collected longitudinal data during and post-campus closure in the current study to investigate the relationship between sleep disturbance and aggression. Methods Data from 665 college students (59.2% females, Meanage = 19.01, SD age = 1.25) were collected before (wave 1) and after (wave 2) the campus closure of COVID-19. All participants were asked to fill out the Buss-Perry Aggression Questionnaire and the Youth Self-Rating Insomnia Scale. Two symptom networks and a cross-lagged panel network were formed and tested. Results Hostility has the highest centrality in the symptom network both in waves 1 and 2, and it bridges sleep disturbance and aggression. "Easily be woken" - "wake up too early" and "wake up with tired" - "function hindrance" are two important symptom associations in networks of waves 1 and 2. All symptoms except "difficulty in falling asleep" and "easily be woken" ameliorated after closure. Moreover, "physical aggression" and "hostility" can trigger other symptoms in wave 2. Conclusion As the first study about aggression and sleep disturbance in the background of COVID-19, we provide valuable information about the relationship between sleep disturbance and aggression on the symptom dimension.
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Affiliation(s)
- Jinhua Zou
- Lianyungang Fourth People's Hospital, Lianyungang, China
| | - Baohua Bian
- Lianyungang Fourth People's Hospital, Lianyungang, China
| | - Min Li
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Gang Liu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
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Lee CKK, Chan KNJ, Wong SMC, Wong HSG, Lei HCJ, So YK, Fung SCV, Chu STR, Chung KKA, Cheng PWC, Lo KYH, Chan WC, Chang WC. Relationships between psychopathological symptoms, pandemic-related stress, perceived social support, and COVID-19 infection history: a network analysis in Chinese college students. Front Psychiatry 2024; 15:1340101. [PMID: 38370557 PMCID: PMC10873916 DOI: 10.3389/fpsyt.2024.1340101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/15/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction Previous coronavirus, 2019 (COVID-19) research has applied network analysis to examine relationships between psychopathological symptoms but rarely extended to potential risk and protective factors or the influence of COVID-19 infection history. This study examined complex inter-relationships between psychopathological symptoms, COVID-19-related stressors, perceived social support, and COVID-19 infection history among Chinese university/college students during the peak of fifth pandemic wave using a network analysis approach. Methods A Least Absolute Shrinkage and Selection Operator-regularized partial correlation network using Gaussian graphical model was constructed in 1,395 Chinese university/college students in Hong Kong who completed a survey between 15 March and 3 April, 2022. Depressive, anxiety, and acute/traumatic stress symptoms were measured by Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Impact of Event Scale-6, respectively. COVID-19-related stressors and perceived social support were measured. Network differences by COVID-19 infection history (COVID-network vs. no_COVID-network) and network communities were examined. Results Our results showed that the most influential nodes were depressed mood, uncontrollable worries, and uncontrollable thoughts about COVID-19. The main bridging symptoms were concentration problems and psychomotor problems. The COVID-network, comprising participants with a history of COVID-19 infection only, was significantly stronger than the no_COVID-network. Perceived social support and stress from conflicts with family/friends formed a unique community with negative cognition and suicidal idea in the COVID-network only. Conclusion Our findings indicate that specific interventions targeting interpersonal conflicts and concentration problems as well as facilitating stress buffering effects of social support may represent effective strategies to reduce psychological distress in university/college students during COVID-19 and should be considered for future pandemic preparedness.
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Affiliation(s)
- Chi Kei Krystal Lee
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kwun Nam Joe Chan
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sau Man Corine Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hou Sem Gabbie Wong
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hiu Ching Janet Lei
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yuen Kiu So
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shi Cheng Vivian Fung
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sai Ting Ryan Chu
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kar Kin Albert Chung
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Pak Wing Calvin Cheng
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ka Ying Heidi Lo
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai Chi Chan
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Workneh F, Worku A, Assefa N, Berhane Y. Network analysis of mental health problems among adults in Addis Ababa, Ethiopia: a community-based study during the COVID-19 pandemic. BMJ Open 2024; 14:e075262. [PMID: 38253451 PMCID: PMC10806846 DOI: 10.1136/bmjopen-2023-075262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE COVID-19 has negatively impacted mental health of adults globally with increased rates of psychiatric comorbidities. However, network analysis studies to examine comorbidities and correlations between symptoms of different mental disorders are uncommon in low-income countries. This study aimed to investigate the network structure of depression, anxiety and perceived stress among adults in Addis Ababa and identify the most central and bridge symptoms within the depressive-anxiety-perceived symptoms network model. DESIGN Community-based cross-sectional study. SETTING This study was carried out on a sample of the general population in Addis Ababa during the first year of the COVID-19 pandemic. A total of 1127 participants were included in this study, of which 747 (66.3%) were females, and the mean age was 36 years. PRIMARY AND SECONDARY OUTCOME MEASURES Symptoms of depression, anxiety and stress were measured using the Patient Health Questionnaire, Generalized Anxiety Disorder Scale and the Perceived Stress Scale, respectively.Network analysis was conducted to investigate the network structure. The centrality index expected influence (EI) and bridge EI (1-step) were applied to determine the central and bridge symptoms. Case-dropping procedure was used to examine the network stability. RESULT The sad mood (EI=1.52) was the most central and bridge symptom in the depression, anxiety and perceived stress network model. Irritability (bridge EI=1.12) and nervousness and stressed (bridge EI=1.33) also served as bridge symptoms. The strongest edge in the network was between nervousness and uncontrollable worry (weight=0.36) in the anxiety community. The network had good stability and accuracy. The network structure was invariant by gender and age based on the network structure invariance test. CONCLUSIONS In this study, the sad mood was the core and bridge symptom. This and the other central and bridge symptoms identified in the study should be targeted to prevent mental health disorders and comorbidities among adults.
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Affiliation(s)
- Firehiwot Workneh
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yemane Berhane
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Hu L, Wang Z, Yang Y, Liu X. Psychometric properties of the Youth Self-rated Insomnia Scale (YSIS) in adolescent psychiatric patients. Sleep Biol Rhythms 2024; 22:103-111. [PMID: 38476857 PMCID: PMC10900025 DOI: 10.1007/s41105-023-00487-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/29/2023] [Indexed: 03/14/2024]
Abstract
The 8-item Youth Self-rated Insomnia Scale (YSIS) was developed to assess insomnia severity in the past month among youths. The YSIS has satisfactory psychometric properties in the general adolescent population. This study examined psychometric properties of the YSIS in a large sample of adolescent psychiatric patients. A total of 536 patients aged 10-19 years were consecutively recruited from the outpatient department of Shandong Mental Health Center between December 2021 and March 2022. Patients completed a structured questionnaire consisting of the YSIS scale and questions about sleep duration, nightmares, psychiatric history, depression, psychiatric and sleep medications, and demographics. Patients were diagnosed following the ICD-10 criteria. Of the participants, the mean age was 15.30 years (SD = 1.95), 61.0% were female, 60.9% were diagnosed with mood disorders, 65.7% were on antidepressants, and 49.0% were on anxiolytics or hypnotics. The mean YSIS score was 22.6 (SD = 8.07). Coefficient omega was 0.84. Exploratory factor analysis revealed one factor and two correlated residuals. The YSIS scores were significantly correlated with depression scores (r = 0.68) and significantly increased with sleep onset latency, short sleep duration, nightmare frequency, and sleep medication use. The YSIS demonstrated satisfactory internal consistency reliability, construct validity, and criteria-related validity in adolescent psychiatric patients. The YSIS appears to be a reliable and valid scale for measuring insomnia severity in adolescent psychiatric patients.
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Affiliation(s)
- Lei Hu
- Shandong Mental Health Center, Shandong University, 49 Wen Hua Dong Road, Jinan, 250014 China
| | - Ziyang Wang
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL 32306 USA
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA 19104 USA
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Park M, Seo D, Kim JG, Lee G, McReynolds LS, Amsel L, Yang H, Kim YH, Han S, Park SH, Hur J. Identification and comparison of pandemic-to-symptom networks of South Korea and the United States. Front Psychiatry 2023; 14:1161200. [PMID: 37426108 PMCID: PMC10328092 DOI: 10.3389/fpsyt.2023.1161200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/16/2023] [Indexed: 07/11/2023] Open
Abstract
Background The 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 methods Using 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). Results The 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. Conclusion The 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.
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Affiliation(s)
- Mijeong Park
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Deachul Seo
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Ji Geun Kim
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Gayeon Lee
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Larkin S. McReynolds
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, United States
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Lawrence Amsel
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, United States
| | - Hyunjung Yang
- University College, Yonsei University, Seoul, Republic of Korea
| | - Young-Hoon Kim
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Sanghoon Han
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Soo Hyun Park
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Juyoen Hur
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
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Yang T, He Y, He C, Yang Y, Wu L, Wei B, Dong R, Yang M, Pu Z, Wang S, Li J, Xu T, Liu X, Wu S. The relationship between anxiety and internet gaming disorder in children during COVID-19 lockdown: a network analysis. Front Psychiatry 2023; 14:1144413. [PMID: 37265552 PMCID: PMC10229880 DOI: 10.3389/fpsyt.2023.1144413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/11/2023] [Indexed: 06/03/2023] Open
Abstract
Background Internet gaming disorder (IGD) has become a social problem in children. Evidence from previous studies has proven that anxiety is associated with IGD. However, IGD was always assessed as a whole based on total scores, and the fine-grained relationship between anxiety and IGD was hidden. Objective The present study aims to investigate the fine-grained relationship between anxiety and IGD in elementary school students during the COVID-19 lockdown, and to identify potential targets for psychological interventions. Methods During the lockdown caused by the COVID-19 pandemic, 667 children from a primary school in China were investigated by the Spence Children's Anxiety Scale-Short Version and Internet Gaming Disorder Scale. R4.1.1 software was used to construct a network model, assess bridge centrality, and test the robustness of the network and conduct a network. Results There were 23 cross-community edges (weight ranged from -0.03 to 0.12), and each node of anxiety was connected to different nodes of IGD. The nodes with the top 80th percentile bridge expected influence were A2 "social phobia" (0.20), A3 "panic disorder" (0.21) and IGD5 "escape" (0.22). The robustness of the network was acceptable. Conclusion From the perspective of network analysis, the present study explored the correlation pathways between anxiety and IGD in children and identified social phobia and panic disorder as the best targets for intervention to reduce IGD.
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Affiliation(s)
- Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yang He
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Chunyan He
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Yueqi Yang
- Xiong’an Rongxi Linquan Primary School, Xiong’an New Area, China
| | - Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Bin Wei
- Xijing Hospital, Air Force Medical University, Xi’an, China
| | - Ruina Dong
- Tangdu Hospital, Air Force Medical University, Xi’an, China
| | - Mengyuan Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Zhaojun Pu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Saiming Wang
- The First Primary School of Fuliang County, Jingdezhen, China
| | - Jing Li
- School of Public Health, Xi’an Medical University, Xi’an, China
| | - Tao Xu
- Psychology Section, Secondary Sanatorium of Air Force Healthcare Center for Special Services, Hangzhou, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
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Jin Y, Li J, Ye J, Luo X, Wilson A, Mu L, Zhou P, Lv Y, Wang Y. Mapping associations between anxiety and sleep problems among outpatients in high-altitude areas: a network analysis. BMC Psychiatry 2023; 23:341. [PMID: 37189050 PMCID: PMC10184966 DOI: 10.1186/s12888-023-04767-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Anxiety and sleep problems are common comorbidities among outpatients living in high-altitude areas. Network analysis is a novel method to investigate the interaction and the association between symptoms across diverse disorders. This study used network analysis to investigate the network structure symptoms of anxiety and sleep problems among outpatients in high-altitude areas, and to explore the differences in symptom associations in various sex, age, educational levels and employment groups. METHODS The data was collected from the Sleep Medicine Center of The First People's Hospital of Yunnan Province from November 2017 to January 2021 with consecutive recruitment (N = 11,194). Anxiety and sleep problems were measured by the Chinese version of the seven-item Generalized Anxiety Disorder Scale (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI) respectively. Central symptoms were identified based on centrality indices and bridge symptoms were identified with bridge indices. The difference of network structures in various sex, age, educational levels and employment groups were also explored. RESULTS Among all the cases, 6,534 (58.37%; 95% CI: 57.45-59.29%) reported experiencing anxiety (GAD-7 total scores ≥ 5), and 7,718 (68.94%; 95% CI: 68.08-69.80%) reported experiencing sleep problems (PSQI total scores ≥ 10). Based on the results of network analysis, among participants, "Nervousness", "Trouble relaxing", "Uncontrollable worry" were the most critical central symptoms and bridge symptoms within the anxiety and sleep problems network structure. The adjusted network model after controlling for covariates was significantly correlated with the original (r = 0.75, P = 0.46). Additionally, there were significant differences in edge weights in the comparisons between sex, age and educational levels groups (P < 0.001), while the employed and unemployed groups did not show significant differences in edge weights (P > 0.05). CONCLUSIONS In the anxiety and sleep problems network model, among outpatients living in high-altitude areas, nervousness, uncontrollable worry, and trouble relaxing were the most central symptoms and bridge symptoms. Moreover, there were significant differences between various sex, age and educational levels. These findings can be used to provide clinical suggestions for psychological interventions and measures targeting to reduce symptoms that exacerbate mental health.
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Affiliation(s)
- Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Jing Ye
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xianyu Luo
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Lanxue Mu
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Pinyi Zhou
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Yunhui Lv
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Brown LA, Zhu Y, Hamlett GE, Moore TM, DiDomenico GE, Visoki E, Greenberg DM, Gur RC, Gur RE, Barzilay R. COVID-19 Worries and Insomnia: A Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4568. [PMID: 36901578 PMCID: PMC10001605 DOI: 10.3390/ijerph20054568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic was associated with significant increases in sleep disorder symptoms and chronic worry. We previously demonstrated that worry about the pandemic was more strongly associated with subsequent insomnia than the converse during the acute (first 6 months) phase of the pandemic. In this report, we evaluated whether that association held over one year of the pandemic. Participants (n = 3560) completed self-reported surveys of worries about the pandemic, exposure to virus risk factors, and the Insomnia Severity Index on five occasions throughout the course of one year. In cross-sectional analyses, insomnia was more consistently associated with worries about the pandemic than exposure to COVID-19 risk factors. In mixed-effects models, changes in worries predicted changes in insomnia and vice versa. This bidirectional relationship was further confirmed in cross-lagged panel models. Clinically, these findings suggest that during a global disaster, patients who report elevations in either worry or insomnia should be considered for evidence-based treatments for these symptoms to prevent secondary symptoms in the future. Future research should evaluate the extent to which dissemination of evidence-based practices for chronic worry (a core feature of generalized anxiety disorder or illness anxiety disorder) or insomnia reduces the development of co-occurring symptoms during a global disaster.
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Affiliation(s)
- Lily A. Brown
- Department of Psychiatry, School of Medicine, University of Pennsylvania Perelman, 3535 Market Street Suite 600N, Philadelphia, PA 19104, USA
| | - Yiqin Zhu
- Department of Psychiatry, School of Medicine, University of Pennsylvania Perelman, 3535 Market Street Suite 600N, Philadelphia, PA 19104, USA
| | - Gabriella E. Hamlett
- Department of Psychiatry, School of Medicine, University of Pennsylvania Perelman, 3535 Market Street Suite 600N, Philadelphia, PA 19104, USA
| | - Tyler M. Moore
- Department of Psychiatry, School of Medicine, University of Pennsylvania Perelman, 3535 Market Street Suite 600N, Philadelphia, PA 19104, USA
- Lifespan Brain Institute of the Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA
| | - Grace E. DiDomenico
- Lifespan Brain Institute of the Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA
| | - Elina Visoki
- Lifespan Brain Institute of the Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA
| | - David M. Greenberg
- Department of Music, Bar Ilan University, Ramat Gan 5290002, Israel
- Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan 5290002, Israel
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge CB2 8AH, UK
| | - Ruben C. Gur
- Department of Psychiatry, School of Medicine, University of Pennsylvania Perelman, 3535 Market Street Suite 600N, Philadelphia, PA 19104, USA
- Lifespan Brain Institute of the Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA
| | - Raquel E. Gur
- Department of Psychiatry, School of Medicine, University of Pennsylvania Perelman, 3535 Market Street Suite 600N, Philadelphia, PA 19104, USA
- Lifespan Brain Institute of the Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA
| | - Ran Barzilay
- Department of Psychiatry, School of Medicine, University of Pennsylvania Perelman, 3535 Market Street Suite 600N, Philadelphia, PA 19104, USA
- Lifespan Brain Institute of the Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA
- Department of Child Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
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9
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Ramos-Vera C, García O'Diana A, Basauri MD, Calle DH, Saintila J. Psychological impact of COVID-19: A cross-lagged network analysis from the English Longitudinal Study of Aging COVID-19 database. Front Psychiatry 2023; 14:1124257. [PMID: 36911134 PMCID: PMC9992548 DOI: 10.3389/fpsyt.2023.1124257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
Background The COVID-19 pandemic and its subsequent health restrictions had an unprecedented impact on mental health, contributing to the emergence and reinforcement of various psychopathological symptoms. This complex interaction needs to be examined especially in a vulnerable population such as older adults. Objective In the present study we analyzed network structures of depressive symptoms, anxiety, and loneliness from the English Longitudinal Study of Aging COVID-19 Substudy over two waves (Months of June-July and November-December 2020). Methods For this purpose, we use measures of centrality (expected and bridge-expected influence) in addition to the Clique Percolation method to identify overlapping symptoms between communities. We also use directed networks to identify direct effects between variables at the longitudinal level. Results UK adults aged >50 participated, Wave 1: 5,797 (54% female) and Wave 2: 6,512 (56% female). Cross-sectional findings indicated that difficulty relaxing, anxious mood, and excessive worry symptoms were the strongest and similar measures of centrality (Expected Influence) in both waves, while depressive mood was the one that allowed interconnection between all networks (bridge expected influence). On the other hand, sadness and difficulty sleeping were symptoms that reflected the highest comorbidity among all variables during the first and second waves, respectively. Finally, at the longitudinal level, we found a clear predictive effect in the direction of the nervousness symptom, which was reinforced by depressive symptoms (difficulties in enjoying life) and loneliness (feeling of being excluded or cut off from others). Conclusion Our findings suggest that depressive, anxious, and loneliness symptoms were dynamically reinforced as a function of pandemic context in older adults in the UK.
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Affiliation(s)
- Cristian Ramos-Vera
- Research Area, Faculty of Health Sciences, Universidad César Vallejo, Lima, Peru
- Sociedad Peruana de Psicometría, Lima, Peru
| | - Angel García O'Diana
- Research Area, Faculty of Health Sciences, Universidad César Vallejo, Lima, Peru
- Sociedad Peruana de Psicometría, Lima, Peru
| | - Miguel Delgado Basauri
- Sociedad Peruana de Psicometría, Lima, Peru
- Postgraduate School, Universidad Femenina del Sagrado Corazón, Lima, Peru
| | - Dennis Huánuco Calle
- Research Area, Faculty of Health Sciences, Universidad César Vallejo, Lima, Peru
- Sociedad Peruana de Psicometría, Lima, Peru
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10
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Tao Y, Niu H, Li Y, Liu X, Wang S, Ma Z, Hou W, Liu X. Effects of personal relative deprivation on the relationship between anger rumination and aggression during and after the COVID-19 pandemic lockdown: A longitudinal moderated network approach. J Adolesc 2023; 95:596-608. [PMID: 36638841 DOI: 10.1002/jad.12140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 01/02/2023] [Accepted: 01/02/2023] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Several studies have demonstrated a directional link between rage rumination and aggression. However, recent research suggests that this relationship is bidirectional. The current study examined the complex relationships between anger rumination and aggression using a moderated network approach in a longitudinal design while considering personal relative deprivation. METHOD A total of 665 participants (59.25% female, agemean±SD = 19.01 ± 1.25) were enrolled at two-time points. Assessments included self-report measures of the Anger Rumination Scale, Buss-Perry Aggression Questionnaire, and Relative Deprivation Scale. A Moderated Network Model (MMN) was used to test the complex links among anger rumination, aggression, and personal relative deprivation. RESULTS The analysis revealed that the link between anger rumination and aggression was complex and bidirectional. Notably, as the level of personal relative deprivation increased, verbal aggression had a positive conditional effect on anger afterthoughts in Wave 2, and thoughts of revenge had a positive conditional effect on verbal aggression in Wave 2. Moreover, as the first discovery, anger afterthoughts and anger had a negative conditional effect on each other across levels of personal relative deprivation in Wave 2. In addition, network comparison indicates that the MNMs structure was significantly different across timepoints, implying that anger rumination and aggression were inextricably linked in college students during isolation and that this complicated relationship was weakened after isolation. CONCLUSIONS This study deepens our understanding of the bidirectional relationships between anger rumination and aggression and recognizes the moderating role of personal relative deprivation.
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Affiliation(s)
- Yanqiang Tao
- Faculty of Psychology, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Haiqun Niu
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Yue Li
- Faculty of Arts, Shenzhen University, Shenzhen, China
| | - Xueting Liu
- Department of Student Affairs Management, Mudanjiang Normal University, Mudanjiang, China
| | - Shujian Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Zijuan Ma
- School of Psychology, South China Normal University, Guangzhou, China
| | - Wenxin Hou
- Faculty of Psychology, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Xiangping Liu
- Faculty of Psychology, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
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11
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Fong TCT, Chang K, Ho RTH. Association between quarantine and sleep disturbance in Hong Kong adults: The mediating role of COVID-19 mental impact and distress. Front Psychiatry 2023; 14:1127070. [PMID: 36926466 PMCID: PMC10011175 DOI: 10.3389/fpsyt.2023.1127070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/06/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND COVID-19 quarantine has been associated with increased sleep problems and prolonged psychological responses to the pandemic could mediate this relationship. The present study attempted to examine the mediating role of COVID-19 mental impact and distress between quarantine and sleep disturbance. METHODS The present study recruited 438 adults (109 with quarantine experience) in Hong Kong via an online survey between August and October 2021. The respondents completed a self-report questionnaire on quarantine, Mental Impact and Distress Scale: COVID-19 (MIDc), and Pittsburgh Sleep Quality Index (PSQI). The MIDc was treated as a latent mediator and continuous PSQI factor and poor sleep quality (PSQI score > 5) were the study outcomes. We evaluated the direct and indirect effects of quarantine on sleep disturbance via MIDc using structural equation modeling. Analyses were adjusted for gender, age, education level, knowing confirmed COVID-19 cases, COVID-19 frontline work, and primary income source of the family. RESULTS More than half (62.8%) of the sample reported poor sleep quality. Quarantine was associated with significantly higher levels of MIDc and sleep disturbance (Cohen d = 0.23 - 0.43, p < 0.05). In the structural equation model, the MIDc mediated the relationship between quarantine and sleep disturbance (αβ = 0.152, 95% CI = 0.071 to 0.235). Quarantine significantly increased the proportion of poor sleep quality by 10.7% (95% CI = 0.050 to 0.171) indirectly via MIDc. CONCLUSIONS The results provide empirical support to the mediating role of the MIDc as psychological responses in the relationship between quarantine and sleep disturbance.
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Affiliation(s)
- Ted C T Fong
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Kay Chang
- Department of Psychology, Faculty of Social Sciences, University of Macao, Macao, Macao SAR, China
| | - Rainbow T H Ho
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.,Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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12
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Shi C, Wang S, Tang Q, Liu X, Li Y. Cross-lagged relationship between anxiety, depression, and sleep disturbance among college students during and after collective isolation. Front Public Health 2022; 10:1038862. [PMID: 36561855 PMCID: PMC9766954 DOI: 10.3389/fpubh.2022.1038862] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Object Repeated quarantine policies over the past 3 years have led to poor psychological consequences for the public. Previous studies have proved that the quarantine policy leaves individuals vulnerable to anxiety, depression, and insomnia, especially among college students. This study aims to explore whether psychological problems during isolation continue with the release of isolation. Methods Overall, 2,787 college students both answered a web-based survey during and after the closure management was lifted. The Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Youth Self-rating Insomnia Scale were measured. The cross-lagged path model was used to explore the influence of psychological impact during isolation on the individual after the release. Results We found that anxiety and sleep disturbance levels alleviated significantly after quarantine, except for depression. As expected, a bidirectional relationship exists between anxiety, depression, and sleep disturbance. Moreover, depression and sleep disturbance can predict post quarantine depression, sleep disturbance, and anxiety, yet anxiety cannot predict sleep disturbance afterward. Conclusion Timely and effective intervention for anxiety, depression, and insomnia during isolation is essential for individuals to repair themselves quickly after the release.
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Affiliation(s)
- Congying Shi
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Shujian Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Qihui Tang
- Faculty of Psychology, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Xiangping Liu
- Faculty of Psychology, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Yue Li
- Faculty of Arts, Shenzhen University, Shenzhen, China,*Correspondence: Yue Li
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Wang S, Hou W, Tao Y, Ma Z, Li K, Wang Y, Xu Z, Liu X, Zhang L. Mapping network connection among symptoms of anxiety, depression, and sleep disturbance in Chinese high school students. Front Public Health 2022; 10:1015166. [PMID: 36466464 PMCID: PMC9710521 DOI: 10.3389/fpubh.2022.1015166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/31/2022] [Indexed: 01/27/2023] Open
Abstract
Background Due to tremendous academic pressure, Chinese high school students suffer from severe depression, anxiety, and sleep disturbances. Moreover, senior high school students commonly face more serious mental health problems than junior high school students. However, the co-occurrence and internal relationships of depression, anxiety, and sleep disturbances clusters are scarcely examined among high students. Therefore, the current study inspected relationships between depression, anxiety, and sleep disturbance symptoms through network analysis and identified key symptoms bolstering the correlation and intensifying the syndromes. Methods A total of 13,999 junior high school students (M age = 13.42 years, SD age = 1.35, 50% females) and 12,550 senior high school students (M age = 16.93 years, SD age = 1.67, 47% females) were recruited in Harbin. We constructed networks for all students, junior high group, and senior high group, including data from the Youth Self-rating Insomnia Scale-3 (YSIS-3), the Generalized Anxiety Disorder-2 (GAD-2), and the Patient Health Questionnaire-2 (PHQ-2). The indices of "strength" was used to identify symptoms' centrality, and "bridge strength" was used to find specific nodes that could bridge anxiety, depression, and sleep disturbance. Results The networks of all students, junior high and senior high students, were stable and accurate. Among all networks, "Nervousness" (GAD1) had the highest strength, and "Nervousness"-"Excessive worry" (GAD1-GAD2) had the strongest correlation. "Nervousness" (GAD1) also functioned as the bridge symptom among junior high students, while "Sad mood" (PHQ2) among senior high students. Senior high students scored higher than junior high students on all items and had a tighter network structure. Conclusions In networks consisting of anxiety, depression, and sleep disturbance, anxiety plays a conspicuous role in comorbidity among junior high school students, which transforms into depression among senior high school students. Treatments or interventions should be focused on these critical symptoms.
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Affiliation(s)
- Shujian Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Wenxin Hou
- Faculty of Psychology, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Yanqiang Tao
- Faculty of Psychology, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Zijuan Ma
- School of Psychology, South China Normal University, Guangzhou, China
| | - Kai Li
- Bengbu Second Middle School, Bengbu, China
| | - Yanling Wang
- The First Psychiatric Hospital of Harbin, Harbin, China
| | - Zhaoyuan Xu
- The First Psychiatric Hospital of Harbin, Harbin, China
| | - Xiangping Liu
- Faculty of Psychology, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Liang Zhang
- College Students' Mental Health Education Center, Northeast Agricultural University, Harbin, China,College of Education for the Future, Beijing Normal University, Zhuhai, China,*Correspondence: Liang Zhang
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Cao C, Meng Q. The dual processes of health impairment and motivation in international student adjustment in China: insights from a demands-resources model. CURRENT PSYCHOLOGY 2022; 42:1-14. [PMID: 35990205 PMCID: PMC9376581 DOI: 10.1007/s12144-022-03630-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 11/06/2022]
Abstract
China has become one of the leading study abroad destinations worldwide. Recent research also indicates that international students encounter diverse life challenges and mental health issues in China. Therefore, scholars have shown increasing interest in their adjustment in Chinese social and academic settings. Seeking theoretical guidance from the Job Demands-Resources Model with mediation and moderation assumptions, our study aimed to test the dual processes (i.e., the health impairment process and the motivational process) leading to academic, sociocultural, and psychological adjustment, among international students sojourning in China. Using a convenience sampling method, our study recruited 1,001 participants (535 males and 466 females; M age = 22.73; SD = 1.62) who completed an online survey including scales of perceived cultural distance (contextual demands), social support from local members (contextual resources), coping self-efficacy (personal resources), acculturative stress, intercultural engagement, as well as three types of cross-cultural adjustment (academic, sociocultural, and psychological adjustment). Results based on the structural equation modeling (SEM) analyses indicated that perceived cultural distance had indirect relationships with the three types of adjustment through the mediator of acculturative stress. Social support from locals had indirect relationships with the three types of adjustment through the mediators of acculturative stress and intercultural engagement. Coping self-efficacy had indirect relationships with academic and sociocultural adjustment through the mediator of intercultural engagement. Additionally, social support from locals was revealed as a moderator that buffered the relationship between perceived cultural distance and acculturative stress. These mediated and moderated relationships not only confirmed the dual processes underlying international student adjustment, but also added new knowledge of how demands and resources can interplay to predict the dual processes.
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Affiliation(s)
- Chun Cao
- Northeast Normal University, 5268, Renmin Street, Changchun, China
| | - Qian Meng
- Changchun University of Science and Technology, 7186, Weixing Road, Changchun, China
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