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Observational Study
. 2023 Dec 19:11:1298693.
doi: 10.3389/fpubh.2023.1298693. eCollection 2023.

The combined impact of social networks and connectedness on anxiety, stress, and depression during COVID-19 quarantine: a retrospective observational study

Huiting Luo #  1 , Dan Luo #  1 , Qiao Tang  1 , Zhiang Niu  1 , Jiajun Xu  1 , Jing Li  1
Affiliations
Observational Study

The combined impact of social networks and connectedness on anxiety, stress, and depression during COVID-19 quarantine: a retrospective observational study

Huiting Luo et al. Front Public Health. .

Abstract

Introduction: The COVID-19 pandemic and associated quarantine measures have precipitated a surge in mental health disorders, particularly depression and anxiety. Government policies and restrictions on physical activity have contributed to this phenomenon, as well as diminished subjective social connectedness and exacerbated objective social isolation. As two dimensions of social isolation, it is worth noting that subjectively perceived social connectedness serves as a protective factor for mental health, whereas the decline in the size of objectively evaluated social networks poses a significant risk. However, research investigating the combined influence of these two dimensions remains limited.

Methods: This study used an online survey to collect data to investigate the effects of objective social connectedness and objective social networks on anxiety, stress, and depression during COVID-19 quarantine. A total of 485 participants were analyzed using statistical methods, including paired t-test, Pearson correlation analysis, linear regression, cluster analysis, ANOVA, and moderated mediated.

Results: The study found that anxiety and depression scores increased during the quarantine, with age, education, and social connectedness scores associated with the increase. Pre-quarantine anxiety and depression levels were strongly correlated with mental health status during quarantine. Cluster analysis, respectively, revealed three clusters for those without increasing anxiety and depression scores. The study also found that objective social network influences the impact of subjective social connectedness on pre-quarantine mental health, which in turn affects anxiety and depression levels during quarantine.

Conclusion: The study identified that quarantine increased anxiety and depression, with age being protective, and education and subjective social connectedness as risk factors. The study also emphasizes the comprehensive impact of objective and subjective social isolation. Although individuals perceive the same degree of social connectedness, those with smaller social networks are more prone to developing symptoms of anxiety and depression, which are also more likely to worsen during quarantine.

Keywords: COVID-19; anxiety; depression; moderated mediation; social connectedness; social isolation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Correlation matrix of the main variables (N = 485). *p < 0.05, **p < 0.01, ***p < 0.001. SNI = Berkman-Syme social network index; Depression.d. = Change in Depression Score During the Quarantine minus Pre-quarantine Depression Score; Anxiety. d. = Change in Anxiety Score During the Quarantine minus Pre-quarantine Anxiety Score; SCS_R.B. = Pre-quarantine Levels of Social Connectedness Scale-Revised; Anxiety. A. = Anxiety Score During the Quarantine; Depression. A. = Depression Score During the Quarantine; Stress. A. = Stress Score During the Quarantine; SCS_R.A. = Levels of Social Connectedness Scale-Revised During the Quarantine; Anxiety. B.= Pre-quarantine Anxiety Score; Depression.B. = Pre-quarantine Depression Score; Stress. B. = Pre-quarantine Stress Score.
Figure 2
Figure 2
Analysis of clustering trends and clustering effects. (A) Cluster trend analysis of the population with no increase in anxiety scores (Anxiety.d. ≤ 0): Hanxiety = 0.8661411; (B) Cluster trend analysis of the population with no increase in depression scores (Depression.d.≤0): Hdepression = 0.7695719; (C) Cluster effect analysis of the population with no increase in anxiety scores (Anxiety.d.≤0) average silhouette width = 0.33; (D) Cluster effect analysis of the population with no increase in depression scores (Depression.d.≤0) the average silhouette width = 0.26.
Figure 3
Figure 3
Characteristics of the 3 clusters of people whose anxiety scores did not increase during the quarantine. 1 = cluster1; 2 = cluster2; 3 = cluster3. Anxiety. B. = Pre-quarantine Anxiety Score; SCS_R.B. = Pre-quarantine Levels of Social Connectedness Scale-Revised.
Figure 4
Figure 4
Characteristics of the 3 clusters of people whose depression scores did not increase during the quarantine. 1 = cluster1; 2 = cluster2; 3 = cluster3. Depression. B. = Pre-quarantine Depression Score; SCS_R.B. = Pre-quarantine Levels of Social Connectedness Scale-Revised.
Figure 5
Figure 5
Moderated Mediation Model. The mediating role of mental states before quarantine and the moderating role of the score of SNI. SNI = Berkman-Syme social network index; SCS_R.B. = Pre-quarantine Levels of Social Connectedness Scale-Revised; Anxiety.B. = Pre-quarantine Anxiety Score; Depression. B. = Pre-quarantine Depression Score.
Figure 6
Figure 6
Simple slope analysis of the interaction between the degree of social connectedness and social isolation on pre-quarantine mental health status. (A) The interaction on pre-quarantine anxiety; (B) The interaction on pre-quarantine depression; SCS_R.B. = Pre-quarantine Levels of Social Connectedness Scale-Revised; Anxiety. B. = Pre-quarantine Anxiety Score; Depression. B. = Pre-quarantine Depression Score.
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