Anxiety and depressive symptoms in college students during the late stage of the COVID-19 outbreak: a network approach
Open accessAbstract
Mental health problems are common in college students even in the late stage of the coronavirus disease 2019 (COVID-19) outbreak. Network analysis is a novel approach to explore interactions of mental disorders at the symptom level. The aim of this study was to elucidate characteristics of depressive and anxiety symptoms network in college students in the late stage of the COVID-19 outbreak. A total of 3062 college students were included. The seven-item Generalized Anxiety Disorder Scale (GAD-7) and nine-item Patient Health Questionnaire (PHQ-9) were used to measure anxiety and depressive symptoms, respectively. Central symptoms and bridge symptoms were identified based on centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. The strongest direct relation was between anxiety symptoms “Nervousness” and “Uncontrollable worry”. “Fatigue” has the highest node strength in the anxiety and depression network, followed by “Excessive worry”, “Trouble relaxing”, and “Uncontrollable worry”. “Motor” showed the highest bridge strength, followed by “Feeling afraid” and “Restlessness”. The whole network was robust in both stability and accuracy tests. Central symptoms “Fatigue”, “Excessive worry”, “Trouble relaxing” and “Uncontrollable worry”, and critical bridge symptoms “Motor”, “Feeling afraid” and “Restlessness” were highlighted in this study. Targeting interventions to these symptoms may be important to effectively alleviate the overall level of anxiety and depressive symptoms in college students.
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During the COVID-19 pandemic, the mental health of college students was negatively impacted by anxiety, depressive symptoms, and acute stress.
“During the pandemic, the mental health of college students was negatively impacted by anxiety, depressive symptoms, and acute stress, as shown by numerous studies (Bai et al. 2021; Huckins et al. 2020; Ma et al. 2020; Wu et al. 2021).”
From Changes in Mental Health and EEG Biomarkers of Undergraduates Under Different Patterns of Mindfulness (2024) · cites this paper as Bai et al. 2021
The Introduction reports increased depression and anxiety among college students during the COVID-19 outbreak. It also describes long-term stress and psychological distress associated with public-health measures, but does not support the claim specifically about acute stress. (LLM, conf=0.88)
Experimental — accuracy not yet measuredWe exposed a strong correlation between being afraid and being able to relax within the anxiety and depression network structure among CSA male survivors, which was reported in previous network analyses as well.
“We exposed a strong correlation between being afraid and being able to relax within the anxiety and depression network structure among CSA male survivors, which was reported in previous network analyses as well [ 89 , 90 ].”
From Anxiety and Depression Symptoms among Youth Survivors of Childhood Sexual Abuse: A Network Analysis (2023) · cites this paper as [89]
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“During the pandemic, the mental health of college students was negatively impacted by anxiety, depressive symptoms, and acute stress, as shown by numerous studies (Bai et al. 2021; Huckins et al. 2020; Ma et al. 2020; Wu et al. 2021).”
- Authors
- Bai, W., Cai, H., Liu, S., Chen, X., Sha, S., Cheung, T., Lin, J. J., Cui, X., Ng, C. H., & Xiang, Y.-T.
- Affiliations
- University of Macau (MO)
- Qinghai University (CN)
- Capital Medical University (CN)
- Hong Kong Polytechnic University (HK)
- Hong Kong Shue Yan University (CN)
- The University of Melbourne (AU)
- Corresponding author
- Sha, Sha
- Venue
- Translational Psychiatry
- Published
- 2021-12-17
- Volume
- 11
- Issue
- 1
- Pages
- 638-638
- ISSN
- 2158-3188 (ISSN-L)
- PMC
- PMC8678580
- OpenAlex
- W4200444645
- Cited by
- 89
- References
- 46
- Citations by year
- 2026: 14 · 2025: 21 · 2024: 23 · 2023: 23 · 2022: 8
- FWCI
- 13.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Translational Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PolyU Institutional Research Archive (Hong Kong Polytechnic University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Funders
- Universidade de Macau (MYRG2019‐00066‐FHS, 2018ZX09201-014)
- Beijing Municipal Administration of Hospitals (PX2018063)
- National Science and Technology Major Project
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- anxiety symptoms, depressive symptoms, university students, COVID-19 pandemic, symptom networks, central symptoms, bridge symptoms, fatigue, excessive worry, restlessness, mental health
- MeSH terms
- COVID-19, SARS-CoV-2, Anxiety, Depression, Disease Outbreaks, Humans, Students
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