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Network analysis of anxiety and depressive symptoms among nursing students during the COVID-19 pandemic✰
Bai, Wei1,2,3; Xi, Hai Tao4; Zhu, Qianqian5,6; Ji, Mengmeng7; Zhang, Hongyan8; Yang, Bing Xiang9; Cai, Hong1,2,3; Liu, Rui6; Zhao, Yan Jie1,2,3; Chen, Li4; Ge, Zong Mei4; Wang, Zhiwen7; Han, Lin8; Chen, Pan9; Liu, Shuo9; Cheung, Teris10; Tang, Yi Lang11,12; Jackson, Todd13; An, Fengrong6; Xiang, Yu Tao1,2,3
2021-11-01
Source PublicationJournal of Affective Disorders
ISSN0165-0327
Volume294Pages:753-760
Abstract

Background: The 2019 coronavirus disease (COVID-19) pandemic has impacted the mental health and well-being of medical personnel, including nursing students. Network analysis provides a deeper characterization of symptom-symptom interactions in mental disorders. The aim of this study was to elucidate characteristics of anxiety and depressive symptom networks of Chinese nursing students during the COVID-19 pandemic. Method: A total of 932 nursing students were included. Anxiety and depressive symptom were measured using the seven-item Generalized Anxiety Disorder Scale (GAD-7) and two-item Patient Health Questionnaire (PHQ-2), respectively. Central symptoms and bridge symptoms were identified via centrality indices and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. Results: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood had the highest centrality values. Three bridge symptoms (Depressed mood, Nervousness, and Anhedonia) were also identified. Neither gender nor region of residence was associated with network global strength, distribution of edge weights or individual edge weights. Limitations: Data were collected in a cross-sectional study design, therefore, causal relations and dynamic changes between anxiety and depressive symptoms over time could not be inferred. Generalizability of findings may be limited to Chinese nursing students during a particular phase of the current pandemic. Conclusions: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood constituted central symptoms maintaining the anxiety-depression network structure of Chinese nursing students during the pandemic. Timely, systemic multi-level interventions targeting central symptoms and bridge symptoms may be effective in alleviating co-occurring experiences of anxiety and depression in this population.

KeywordAnxiety Covid-19 Depression Network Analysis Nursing Students
DOI10.1016/j.jad.2021.07.072
URLView the original
Indexed BySCIE ; SSCI
Language英語English
WOS Research AreaNeurosciences & Neurology ; Psychiatry
WOS SubjectClinical Neurology ; Psychiatry
WOS IDWOS:000691678200016
Scopus ID2-s2.0-85111604849
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Cited Times [WOS]:4   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionUniversity of Macau
Corresponding AuthorBai, Wei; An, Fengrong; Xiang, Yu Tao
Affiliation1.Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
2.Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
3.Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
4.Jilin University Nursing College, Jilin province, China
5.School of Nursing, Capital Medical University, China
6.The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, China
7.Peking University School of Nursing, China
8.Lanzhou University School of Nursing, Gansu province, China
9.Atlanta VA Medical Center, Decatur, Georgia, United States
10.School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
11.Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, China
12.Atlanta VA Medical Center, Decatur, Georgia, United States
13.Department of Psychology, University of Macau, Taipa, China
First Author AffilicationFaculty of Health Sciences;  University of Macau
Corresponding Author AffilicationFaculty of Health Sciences;  University of Macau
Recommended Citation
GB/T 7714
Bai, Wei,Xi, Hai Tao,Zhu, Qianqian,et al. Network analysis of anxiety and depressive symptoms among nursing students during the COVID-19 pandemic✰[J]. Journal of Affective Disorders,2021,294:753-760.
APA Bai, Wei,Xi, Hai Tao,Zhu, Qianqian,Ji, Mengmeng,Zhang, Hongyan,Yang, Bing Xiang,Cai, Hong,Liu, Rui,Zhao, Yan Jie,Chen, Li,Ge, Zong Mei,Wang, Zhiwen,Han, Lin,Chen, Pan,Liu, Shuo,Cheung, Teris,Tang, Yi Lang,Jackson, Todd,An, Fengrong,&Xiang, Yu Tao.(2021).Network analysis of anxiety and depressive symptoms among nursing students during the COVID-19 pandemic✰.Journal of Affective Disorders,294,753-760.
MLA Bai, Wei,et al."Network analysis of anxiety and depressive symptoms among nursing students during the COVID-19 pandemic✰".Journal of Affective Disorders 294(2021):753-760.
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