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Lv F, Shang B, Luo C, Xu J, Gong Y, Wu J, Chen Y, Li W, Liu J, Ding Z. Differences in networks of alexithymia and cognitive emotion regulation strategies among older adults with different health statuses in eastern China-A network analysis and network comparison. Geriatr Nurs 2024; 59:471-478. [PMID: 39141954 DOI: 10.1016/j.gerinurse.2024.07.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 07/07/2024] [Accepted: 07/30/2024] [Indexed: 08/16/2024]
Abstract
To identify core and bridge nodes in the network structure of alexithymia and cognitive emotion regulation strategies in community-dwelling older adults, and compare network differences among older adults with different health statuses, we recruited 677 participants and network analysis was performed in R 4.2.0. After including the covariates, the nodes Catastrophizing, Difficulty Identifying feelings, and Refocusing on Planning ranked as the top three. The nodes Externally Oriented Thoughts and Difficulty Identifying Feelings were identified as bridge nodes based on bridge strength values. Significant differences were observed between the healthy and comorbidity groups, and also between the single chronic disease and comorbidity groups (p < 0.05). Catastrophizing, Difficulty Identifying Feelings, and Refocusing on Planning were the core nodes, and Externally Oriented Thoughts and Difficulty Identifying Feelings were the key bridge nodes. The network structure of comorbidity in older adults was characterized by stronger ties to non-adaptive cognitive emotion regulation strategies.
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Affiliation(s)
- Fei Lv
- Faculty of Life Sciences and Technology, Jiangsu University Jingjiang College, No.537 Cheung Heung West Avenue, Zhenjiang, Jiangsu, 212000, PR China
| | - Bin Shang
- Department of Nursing, The First People's Hospital of Lianyungang, No. 6 Zhenhua East Road, Lianyungang, Jiangsu, 222000, PR China
| | - Caifeng Luo
- School of Medicine, Jiangsu University, No. 301 Xuefu Road, Zhenjiang, Jiangsu, 212000, PR China.
| | - Jianou Xu
- School of Medicine, Jiangsu University, No. 301 Xuefu Road, Zhenjiang, Jiangsu, 212000, PR China
| | - Yijing Gong
- School of Medicine, Jiangsu University, No. 301 Xuefu Road, Zhenjiang, Jiangsu, 212000, PR China
| | - Jing Wu
- School of Medicine, Jiangsu University, No. 301 Xuefu Road, Zhenjiang, Jiangsu, 212000, PR China
| | - Yijie Chen
- Faculty of Life Sciences and Technology, Jiangsu University Jingjiang College, No.537 Cheung Heung West Avenue, Zhenjiang, Jiangsu, 212000, PR China
| | - Wen Li
- Faculty of Life Sciences and Technology, Jiangsu University Jingjiang College, No.537 Cheung Heung West Avenue, Zhenjiang, Jiangsu, 212000, PR China
| | - Jiayi Liu
- Faculty of Life Sciences and Technology, Jiangsu University Jingjiang College, No.537 Cheung Heung West Avenue, Zhenjiang, Jiangsu, 212000, PR China
| | - Zhen Ding
- Faculty of Life Sciences and Technology, Jiangsu University Jingjiang College, No.537 Cheung Heung West Avenue, Zhenjiang, Jiangsu, 212000, PR China
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Wang K, Diao M, Yang Z, Salvador JT, Zhang Y. Identification of Core Symptom Cluster in Patients With Digestive Cancer: A Network Analysis. Cancer Nurs 2023:00002820-990000000-00178. [PMID: 37903303 DOI: 10.1097/ncc.0000000000001280] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
BACKGROUND A lack of identified core symptom clusters in digestive cancer patients hinders achieving precision symptom intervention. There are few studies on identifying digestive cancer symptom clusters based on network analysis. OBJECTIVES The aims of this study were to construct the symptom network of digestive cancer patients and identify the core symptom cluster. METHODS A cross-sectional study was conducted among 202 digestive cancer patients. The Chinese version of the MD Anderson Symptom Inventory for gastrointestinal cancer scale was used to assess the symptoms by convenience sampling. R software was used to construct a symptom network and identify core symptom clusters. Edge weight and centrality difference tests were used to test the accuracy of core symptom cluster identification. RESULTS The most common symptoms were distress, poor appetite, and sadness. The most serious symptoms were poor appetite, disturbed sleep, and fatigue. The core symptom cluster of the psychoemotional symptom group was distress, sadness, and numbness. The centrality index showed that the top 3 in strength were distress (Rs = 1.11), fatigue (Rs = 1.09), and sadness (Rs = 1.04). The edge weight difference test showed that the psychoemotional symptom group had high stability. CONCLUSIONS The psychoemotional symptoms of digestive cancer patients should be given priority for intervention. Network analysis must be extended to the symptom research of cancer patients as soon as possible to provide a scientific basis for symptom management. IMPLICATIONS FOR PRACTICE Nurses must perform comprehensive psychological and emotional assessments, initiate referrals for psychoemotional symptom management and psychological services, and administer pharmacologic and nonpharmacologic interventions to improve appetite loss in digestive cancer patients.
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Affiliation(s)
- Ke Wang
- Author Affiliations: Department of Nursing, The Second Affiliated Hospital of Shandong First Medical University (Dr Wang, and Mss Diao and Yang), Tai'an City, China; Nursing Education Department, College of Nursing, Imam Abdulrahman Bin Faisal University (Dr Salvador), Dammam, Saudi Arabia; and College of Nursing, Shandong First Medical University (Ms Zhang), Tai'an City, China
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Neill EL, Zarling A, Weems CF. Therapist use of cognitive behavior therapy and eye movement desensitization and reprocessing components for the treatment of posttraumatic stress disorder in practice settings. Front Psychol 2023; 14:1158344. [PMID: 37928599 PMCID: PMC10621788 DOI: 10.3389/fpsyg.2023.1158344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Treatment practice guidelines for posttraumatic stress disorder (PTSD) recommend both Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Behavior Therapy (CBT); however, implementation in practice setting remains challenging. Here we aim to foster implementation efforts for PTSD by identifying the relative use of the various components of empirically supported treatments by therapists and the characteristics that predict their use. Methods Surveyed 346 therapists (84.07% female) of whom 272 participants (78.61%) were trained primarily in CBT and 135 participants (39.02%) were trained in primarily in EMDR. Assessed relative use of various EMDR and CBT components as well as several training and personality factors. Results Psychoeducation about trauma was the most common element used. "Off label" use of components was also identified with application of EMDR techniques to other diagnoses. Findings also suggest underutilization of in vivo exposure techniques across therapists. EMDR therapists reported relatively high use of core EMDR techniques (i.e., greater use of EMDR core techniques). Big five personality factors, therapy efficacy, and anxiety were associated with differential component use. Discussion Results identify trends in empirically supported component use and therapist characteristics that are associated with the use of various techniques for PTSD. The findings suggest implementation efforts could foster training in underused techniques, address barriers to their utilization and develop knowledge of effective packages of components.
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Affiliation(s)
- Erin L. Neill
- Human Development and Family Studies, Iowa State University, Ames, IA, United States
| | | | - Carl F. Weems
- Human Development and Family Studies, Iowa State University, Ames, IA, United States
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Blekić W, Ben Taieb S, Kandana Arachchige KG, Rossignol M, Schultebraucks K. Stress response and experiential avoidance among firefighters: Preliminary insights from network analyses. J Psychiatr Res 2023; 165:132-139. [PMID: 37499484 PMCID: PMC10546386 DOI: 10.1016/j.jpsychires.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/29/2023]
Abstract
Firefighters are at increased risk of developing posttraumatic stress disorder (PTSD) due to exposure to potentially traumatic events during their careers. However, little is known about the prevalence of PTSD among this population, particularly when taking moderating variables into account. Using Gaussian Graphical Models and Directed Acyclic Graphs, we conducted network analyses to examine the interactions between clusters of PTSD symptoms, perceived stress, hardiness, and experiential avoidance among 187 firefighters. The data and code are published with the paper. Experiential avoidance, as part of psychological inflexibility, was found to be the only variable that interacted with PTSD symptomatology. Strong positive associations were observed between experiential avoidance and the "negative mood and cognitions" subscale of the PTSD Checklist for DSM-5 (PCL-5). Through this association, other PTSD symptoms were activated, particularly avoidance and arousal. Our findings suggest that experiential avoidance and negative mood and cognition symptoms are particularly important in the expression of PTSD symptomatology in firefighters. In addition, experiential avoidance may be used as a coping strategy to reduce perceived stress during potentially traumatic events. Therefore, experiential avoidance may be a prime target for future interventions and training focused on flexible self-regulation strategies in this population.
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Affiliation(s)
- Wivine Blekić
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA.
| | - Souhaib Ben Taieb
- Department of Computer Science, University of Mons, Mons, Belgium; Big Data and Machine Learning Lab, University of Mons, Mons, Belgium
| | | | - Mandy Rossignol
- Department of Cognitive Psychology and Neuropsychology, University of Mons, Belgium
| | - Katharina Schultebraucks
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
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Weems CF, McCurdy BH, Scozzafava MD. Toward a Developmental Model of Continuity and Change in PTSD Symptoms following Exposure to Traumatic and Adverse Experiences. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:391-402. [PMID: 37234837 PMCID: PMC10205928 DOI: 10.1007/s40653-021-00398-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 05/28/2023]
Abstract
A developmental understanding of the expression of posttraumatic stress (PTS) symptoms following trauma in childhood requires identifying continuity and change in not just overall symptoms but in the individual symptoms as well. Such models of change also require understanding multiple dimensions of time. That is, longitudinal change-the passage of time-may have different effects on symptom expression depending on when in time an individual entered the study - such as what age they were when first assessed. This paper addresses these ideas with an overview of the developmental differences in the assessment of PTS from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, (DSM-5), longitudinal research on posttraumatic stress disorder (PTSD) symptoms, and providing synthesis within a symptom network perspective. We then provide an illustration of how individual PTSD symptoms change over time at different ages (elementary versus middle school) with a secondary analysis of data from a previously reported study (n = 191 youth, aged 8-15, assessed at two time points six months apart). The reanalysis of the data suggests both continuity and change in symptoms over time (i.e., some symptoms were more stable than other symptoms) with differences in symptom rates and their longitudinal change as a function of age (i.e., some symptoms more common or more stable in younger versus older or older versus younger). We close with avenues for future research aimed at better understanding symptom cascades over time and at different ages and potential implications for future iterations of assessment/classification systems.
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Affiliation(s)
- Carl F. Weems
- Department of Human Development and Family Studies, Iowa State University Ames, 4380, Palmer, IA 50011 USA
| | - Bethany H. McCurdy
- Department of Human Development and Family Studies, Iowa State University Ames, 4380, Palmer, IA 50011 USA
| | - Mikaela D. Scozzafava
- Department of Human Development and Family Studies, Iowa State University Ames, 4380, Palmer, IA 50011 USA
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Jing F, Zhu Z, Qiu J, Tang L, Xu L, Xing W, Hu Y. Contemporaneous symptom networks and correlates during endocrine therapy among breast cancer patients: A network analysis. Front Oncol 2023; 13:1081786. [PMID: 37064124 PMCID: PMC10103712 DOI: 10.3389/fonc.2023.1081786] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
Background Endocrine therapy-related symptoms are associated with early discontinuation and quality of life among breast cancer survivors. Although previous studies have examined these symptoms and clinical covariates, little is known about the interactions among different symptoms and correlates. This study aimed to explore the complex relationship of endocrine therapy-related symptoms and to identify the core symptoms among breast cancer patients. Methods This is a secondary data analysis conducted based on a multicenter cross-sectional study of 613 breast cancer patients in China. All participants completed the 19-item Chinese version of the Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES). Multivariate linear regression analysis was performed to identify significant factors. A contemporaneous network with 15 frequently occurring symptoms was constructed after controlling for age, payment, use of aromatase inhibitors, and history of surgery. Network comparison tests were used to assess differences in network structure across demographic and treatment characteristics. Results All 613 participants were female, with an average age of 49 years (SD = 9.4). The average duration of endocrine therapy was 3.6 years (SD = 2.3) and the average symptom score was 18.99 (SD = 11.43). Irritability (n = 512, 83.52%) and mood swings (n = 498, 81.24%) were the most prevalent symptoms. Lost interest in sex (mean = 1.95, SD = 1.39) and joint pain (mean = 1.57, SD = 1.18) were the most severe symptoms. The edges in the clusters of emotional symptoms ("irritability-mood swings"), vasomotor symptoms ("hot flashes-cold sweats-night sweats"), vaginal symptoms ("vaginal discharge-vaginal itching"), sexual symptoms ("pain or discomfort with intercourse-lost interest in sex-vaginal dryness"), and neurological symptoms ("headaches-dizziness") were the thickest in the network. There were no significant differences in network structure (P = 0.088), and global strength (P = 0.330) across treatment types (selective estrogen receptor modulators vs. aromatase inhibitors). Based on an evaluation of the centrality indices, irritability and mood swings appeared to be structurally important nodes after adjusting for the clinical covariates and after performing subgroup comparisons. Conclusion Endocrine therapy-related symptoms are frequently reported issues among breast cancer patients. Our findings demonstrated that developing targeted interventions focused on emotional symptoms may relieve the overall symptom burden for breast cancer patients during endocrine therapy.
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Affiliation(s)
- Feng Jing
- School of Nursing, Fudan University, Shanghai, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China
| | - Jiajia Qiu
- Department of Nursing Administration, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Lichen Tang
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Lei Xu
- School of Nursing, Fudan University, Shanghai, China
| | - Weijie Xing
- School of Nursing, Fudan University, Shanghai, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China
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Liu R, Duan W. Assessing perceptions of resilience: The understanding from network analysis. Front Public Health 2023; 11:1017871. [PMID: 36741960 PMCID: PMC9895415 DOI: 10.3389/fpubh.2023.1017871] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023] Open
Abstract
Introduction Previous studies have yet to reach a consensus on the construct of resilience perception, and how to enhance the effect of resilience intervention remains an urgent issue. In this consideration, this study examines the fundamental construct of resilience. It provides insight into the critical prevention goal for resilience intervention by utilizing the latest methods of psychological network analysis. Methods The sample is the graduate students enrolled in September 2021. Participants completed (1) the Connor-Davidson Resilience Scale, (2) the University of Washington Resilience Scale-8 Item, (3) the Brief Resilience Scale, and (4) the Resilience Scale for Adults, each representing different orientations of resilience. Results The network analysis grants greater clarity to the resilience perception as a dynamic system that interacts between an individual's tendency to intrinsic capacity and response to external resources. This study has shown that a positive perception of external social resources is the most important for individuals' resilience cognition; the effect of resilience intervention can be achieved more quickly by changing the individual's sense of hope. Discussion Based on the results, a psychometric instrument that integrates different orientations of resilience concepts and is based on time-varying needs to be developed.
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Affiliation(s)
- Rong Liu
- Student Counseling and Mental Health Center, East China University of Science and Technology, Shanghai, China
| | - Wenjie Duan
- Social and Public Administration School, East China University of Science and Technology, Shanghai, China
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Williamson RE, Hoeboer CM, Primasari I, Qing Y, Coimbra BM, Hovnanyan A, Grace E, Olff M. Symptom networks of COVID-19-related versus other potentially traumatic events in a global sample. J Anxiety Disord 2021; 84:102476. [PMID: 34560583 PMCID: PMC8423664 DOI: 10.1016/j.janxdis.2021.102476] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/25/2021] [Accepted: 09/01/2021] [Indexed: 11/28/2022]
Abstract
The potential mental health consequences of the coronavirus disease 2019 (COVID-19) pandemic are widely acknowledged; however, limited research exists regarding the nature and patterns of stress responses to COVID-19-related potentially traumatic events (PTEs) and the convergence/divergence with responses to other (non-COVID-19-related) PTEs. Network analysis can provide a useful method for evaluating and comparing these symptom structures. The present study includes 7034 participants from 86 countries who reported on mental health symptoms associated with either a COVID-19-related PTE (n = 1838) or other PTE (n = 5196). Using network analysis, we compared the centrality and connections of symptoms within and between each group. Overall, results show that the COVID-19-related network includes transdiagnostic symptom associations similar to networks tied to PTEs unrelated to the pandemic. Findings provide evidence for a shared centrality of depression across networks and theoretically consistent connections between symptoms. Network differences included stronger connections between avoidance-derealization and hypervigilance-depression in the COVID-19 network. Present findings support the conceptualization of psychological responses to pandemic-related PTEs as a network of highly interconnected symptoms and support the use of a transdiagnostic approach to the assessment and treatment of mental health challenges related to the COVID-19 pandemic.
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Affiliation(s)
| | - Chris M Hoeboer
- Department of Psychiatry, Amsterdam University Medical Centers Location AMC, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Indira Primasari
- Department of Psychiatry, Amsterdam University Medical Centers Location AMC, Amsterdam Public Health, Amsterdam, The Netherlands; Department of Clinical Psychology, Faculty of Psychology, Universitas Indonesia, Indonesia
| | - Yulan Qing
- Department of Psychiatry, Amsterdam University Medical Centers Location AMC, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Bruno M Coimbra
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ani Hovnanyan
- Department of Developmental Psychology and Socialisation, University of Padua (Università degli Studi di Padova, UNIPD), Italy
| | - Emma Grace
- Department of International Psychology, The Chicago School of Professional Psychology, Washington, DC, United States
| | - Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Centers Location AMC, Amsterdam Public Health, Amsterdam, The Netherlands; ARQ National Psychotrauma Centre, Diemen, The Netherlands
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Frewen P, O'Donnell M, D'Andrea W. Introduction to the Special Issue: Network Analysis of Traumatic Stress. J Trauma Stress 2020; 33:5-9. [PMID: 32208542 DOI: 10.1002/jts.22486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 01/09/2020] [Indexed: 12/18/2022]
Abstract
Network analysis has emerged as a promising new statistical methodology for traumatic stress studies. The present special issue of the Journal of Traumatic Stress amalgamates the reports of 10 studies that employed network analysis to further the field's understanding of traumatic stress. The current issue includes reports of network analyses that sought to better understand the impact of different kinds of traumatic events, including childhood and gender-based trauma exposure, on PTSD symptomatology as defined under the DSM-5 and ICD-11, and examined the relation between PTSD symptoms and trauma-related dissociative experiences as well as the impact of psychological treatment on trauma recovery. A variety of research designs from a diverse group of international samples were employed, including concurrent, longitudinal, experience-sampling, and treatment outcome studies. Finally, a commentary on the articles included in this special issue was provided by Dr. Carl Weems.
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Affiliation(s)
- Paul Frewen
- Departments of Psychiatry and Psychology, Western University, London, Ontario, Canada
| | - Meaghan O'Donnell
- Phoenix Australia, Department Psychiatry, University of Melbourne, Melbourne, Australia
| | - Wendy D'Andrea
- Department of Psychology, The New School, New York, New York, USA
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