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

  • Lee, Chi Kei Krystal1
  • Chan, Kwun Nam Joe1
  • Wong, Sau Man Corine2
  • Wong, Hou Sem Gabbie1
  • Lei, Hiu Ching Janet1
  • So, Yuen Kiu1
  • Fung, Shi Cheng Vivian1
  • Chu, Sai Ting Ryan1
  • Chung, Kar Kin Albert1
  • Cheng, Pak Wing Calvin1
  • Lo, Ka Ying Heidi1
  • Chan, Wai Chi1
  • Chang, Wing Chung1, 3
  • 1 Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong
  • 2 School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
  • 3 State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
Published Article
Frontiers in Psychiatry
Frontiers Media SA
Publication Date
Feb 02, 2024
DOI: 10.3389/fpsyt.2024.1340101
  • Psychiatry
  • Brief Research Report


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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