Relationships between psychopathological symptoms, pandemic-related stress, perceived social support, and COVID-19 infection history: a network analysis in Chinese college students

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.

Keywords: COVID-19; anxiety; depression; network analysis; social support.

Figure 1

(A) Regularized partial correlation network model of depressive, anxiety, and stress symptoms; COVID-19–related stressors; and perceived social support in a sample of university/college students in Hong Kong during the peak of COVID-19 pandemic. Blue lines between two nodes indicate positive correlations, and dotted red lines indicate negative correlations. Predictability of each node is represented by the circles surrounding each node. (B) Expected influence of each node in the network. (C) Bridge expected influence in the network. X-axis represents the z-scores.

Figure 2

(A) Regularized partial correlation network model of depressive, anxiety, and acute stress symptoms; COVID-19 stressors; and perceived social support in a sample of university/college students in Hong Kong during the peak of COVID-19 pandemic by their reported history of COVID-19 infection. Blue lines between two nodes indicate positive correlations and dotted red lines indicate negative correlations. (B) Expected influence of each node in the network. (C, D) One-step bridge expected influence in the COVID and no_COVID networks. X-axis represents the z-scores.