Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;37(4):692-705.
doi: 10.1002/smi.3027. Epub 2021 Feb 4.

Connecting the dots: A network approach to post-traumatic stress symptoms in Chinese healthcare workers during the peak of the Coronavirus Disease 2019 outbreak

Kristof Hoorelbeke  1 , Xiaoxiao Sun  2 , Ernst H W Koster  1 , Qin Dai  2
Affiliations

Connecting the dots: A network approach to post-traumatic stress symptoms in Chinese healthcare workers during the peak of the Coronavirus Disease 2019 outbreak

Kristof Hoorelbeke et al. Stress Health. 2021 Oct.

Erratum in

  • Corrigendum.
    Dai Q. Dai Q. Stress Health. 2022 Feb;38(1):180-181. doi: 10.1002/smi.3113. Epub 2021 Nov 27. Stress Health. 2022. PMID: 34837724 Free PMC article. No abstract available.

Abstract

Healthcare workers are at elevated risk to develop symptoms of post-traumatic stress disorder (PTSD) in response to an outbreak of a highly infectious disease. The current study set-out to model the complex interrelations between PTSD symptoms during the peak of the Coronavirus Disease 2019 outbreak in 291 Chinese healthcare workers and 291 matched control cases that were selected from the general population. For this purpose, we estimated regularized partial correlation networks. Within the network of healthcare workers, we observed a central role for avoidance of reminders of the traumatic event, physiological cue reactivity, anger/irritability, re-experiencing, and startle. We identified three clusters of closely interconnected PTSD symptoms in healthcare workers, consisting of (a) symptoms of re-experiencing and anxious arousal, (b) symptoms of avoidance and amnesia and (c) symptoms of emotional numbing and dysphoric arousal. Respectively, startle, avoidance of reminders and feeling detached emerged as bridging nodes in these communities. Although yielding highly similar network models, the PTSD symptom structure of healthcare workers showed several unique features compared to the matched control sample. This is informative for interventions aimed at targeting PTSD symptoms in healthcare workers in the context of a public health emergency.

Keywords: COVID-19; PTSD; healthcare workers; network analysis; stress; symptom structure.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Regularized partial correlation network model for the post‐traumatic stress disorder symptom structure in Chinese healthcare workers during Coronavirus Disease 2019
FIGURE 2
FIGURE 2
Expected influence for post‐traumatic stress disorder symptoms in Chinese healthcare workers and matched controls during Coronavirus Disease 2019
FIGURE 3
FIGURE 3
Bridge expected influence of post‐traumatic stress disorder symptoms in healthcare workers during Coronavirus Disease 2019
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Adelson, J. L. (2013). Educational research with real data: Reducing selection bias with propensity score analysis. Practical Assessment Research & Evaluation, 18, 15. 10.7275/4nr3-nk33 - DOI
    1. American Psychiatric Association . (2000). Diagnostic and statistical manual of mental disorders. (4th ed. Text Revision). Washington, DC: American Psychiatric Association.
    1. American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
    1. Armour, C. , Fried, E. I. , Deserno, M. K. , Tsai, J. , & Pietrzak, R. H. (2017). A network analysis of DSM‐5 posttraumatic stress disorder symptoms and correlates in US military veterans. Journal of Anxiety Disorders, 45, 49–59. 10.1016/j.janxdis.2016.11.008. - DOI - PubMed
    1. Bartels, L. , Berliner, L. , Holt, T. , JensenJungbluth, T. N. , Plener, P. , Risch, E. , … Sachser, C. (2019). The importance of the DSM‐5 posttraumatic stress disorder symptoms of cognition and mood in traumatized children and adolescents: Two network approaches. The Journal of Child Psychology and Psychiatry, 60, 545–554. - PubMed