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Dieujuste N, Mekawi Y, Doom JR. Examination of race-based traumatic stress symptom networks in Black adults in the United States: A network analysis. J Trauma Stress 2024; 37:397-409. [PMID: 38054549 DOI: 10.1002/jts.23003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 12/07/2023]
Abstract
In the United States, racism is theorized to exert its negative effects on Black individuals' mental health by triggering a response known as "race-based traumatic stress" (RBTS), a multidimensional construct comprising seven clusters of symptoms that can occur following exposure to race-based traumatic events (e.g., racial discrimination, racist incidents): depression, intrusion, anger, hypervigilance, physical symptoms, (low) self-esteem, and avoidance. However, little is known about which symptoms and clusters are strongest and most influential in the maintenance of RBTS. Network analysis is a powerful tool for understanding the etiology of traumatic stress, but it has not yet been applied to the examination of this construct. The present study aimed to identify the symptoms most central to RBTS and examine associations between symptoms and symptom clusters. Participants (N = 1,037) identified as Black, and lived in the United States (Mage = 45.12 years, range: 18-82 years) and completed the Race-Based Traumatic Stress Symptom Scale-Short Form (RBTSSS-SF). Regularized partial correlation networks were estimated using R/RStudio. The cluster- and item-level networks demonstrated adequate centrality stability, CS = .44. The depression and physical symptoms clusters were the most central nodes in the cluster network. Feelings of meaninglessness, experiencing mental images of the event, and physical trembling were the most central items within the item-level network. These findings offer insights and implications for assessing and treating symptoms of RBTS in Black adults in the United States who are exposed to race-based traumatic events.
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Affiliation(s)
| | - Yara Mekawi
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Jenalee R Doom
- Department of Psychology, University of Denver, Denver, Colorado, USA
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Cotter G, Morreale K, Valdegas A, Fish M, Beebe R, Grasso D, Stover C, Tseng WL. Associations between trauma exposure and irritability within the family unit: a network approach. J Child Psychol Psychiatry 2024. [PMID: 38710637 DOI: 10.1111/jcpp.13998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Pediatric irritability is a pervasive psychiatric symptom, yet its etiology remains elusive. While trauma exposure may contribute to the development of irritability, empirical research is limited. This study examined the prevalence of irritability among trauma-exposed children, identified factors that differentiate trauma-exposed children with and without irritability, and employed a network analysis to uncover associations between irritability and trauma exposure in the family unit. METHODS Sample included 676 children (56.3% male, mean age = 9.67 ± 3.7 years) and their parents referred by the Connecticut Department of Children and Families to Fathers for Change - a psychotherapy intervention designed to reduce intimate partner violence (IPV) and child maltreatment. Child's trauma exposure, post-traumatic stress disorder (PTSD) symptoms, and irritability were assessed pre-intervention using self- and caregiver-report. Parents self-reported their childhood and adulthood trauma exposures, PTSD symptoms, irritability, psychopathology, and IPV. RESULTS Across caregiver- and child-reports, 16%-17% of children exhibited irritability. Irritable children experienced greater trauma exposure, interpersonal violence, emotional abuse, and PTSD severity. They had caregivers, particularly mothers, with greater trauma histories, IPV, and psychopathology. Network analysis revealed 10 nodes directly correlated to child's irritability including child's PTSD severity, parental IPV (specifically psychological violence), and parental psychopathology. CONCLUSIONS Results provide initial empirical evidence that pediatric irritability is linked to trauma exposure, suggesting trauma histories be considered in the diagnosis and treatment of irritability. Interventions addressing caregiver trauma, IPV, and psychopathology may ameliorate pediatric irritability. Future studies could benefit from adopting network approaches with longitudinal or time series data to elucidate causality and points of intervention.
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Affiliation(s)
- Grace Cotter
- Yale School of Medicine, Yale Child Study Center, New Haven, CT, USA
- Northeastern University, Boston, MA, USA
| | - Kristina Morreale
- Yale School of Medicine, Yale Child Study Center, New Haven, CT, USA
- Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | | | - Meghan Fish
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Rebecca Beebe
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Damion Grasso
- University of Connecticut School of Medicine, Farmington, CT, USA
| | - Carla Stover
- Yale School of Medicine, Yale Child Study Center, New Haven, CT, USA
| | - Wan-Ling Tseng
- Yale School of Medicine, Yale Child Study Center, New Haven, CT, USA
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Mendonça JMTD, Rebustini F, Sousa AAFD, Eshriqui I, Bonfim D, Almeida LYD. Brazilian Scale for Evaluation of Mental Health Care Needs: Additional Evidence. Rev Saude Publica 2024; 57Suppl 3:7s. [PMID: 38629671 PMCID: PMC11037904 DOI: 10.11606/s1518-8787.2023057005347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 11/03/2023] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To investigate validity evidence of the Brazilian Scale for Evaluation of Mental Health Care Needs (CuidaSM). METHODS This is a psychometric study, which seeks additional evidence of internal structure. Data collection was carried out in 11 Primary Health Care (PHC) services , which implement the Health Care Planning (HCP) methodology, distributed across the five Brazilian regions. The preliminary version of CuidaSM, containing a block self-referred by the user and another block evaluated by PHC professionals, was applied to users aged 18 or over who attended the PHC services for consultation with a higher education professional. The techniques of confirmatory factor analysis and network analysis were used to investigate validity evidence. For the primary data of the confirmatory factor analysis, the factorial loads and the item's predictive power (R2) were used. Six model adjustment indices were adopted and reliability was measured by three indicators using Bayesian estimation. RESULTS A total of 879 users participated in the study. By confirmatory factor analysis, factorial loads ranged from 0.43 to 0.99 and R2 from 0.19 to 0.98. Both the primary indicators and the model adequacy indices were established at satisfactory and consistent levels. The network analysis showed that the items were appropriately associated with their peers, respecting the established dimensions, which again indicates the sustainability and stability of the proposed model. CONCLUSIONS The study findings confirm a consistent and reliable model of the instrument, through a combination of techniques. Considering the importance of using solid instruments in clinical practice, CuidaSM is a promising tool for population-based management and network care organization, aligned with HCP proposals.
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Affiliation(s)
- Joana Moscoso Teixeira de Mendonça
- Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes (CEPPAR). São Paulo, SP, Brasil
| | - Flavio Rebustini
- Universidade de São Paulo. Escola de Artes, Ciências e Humanidades. Departamento de Gerontologia. São Paulo, SP, Brasil
| | - Ana Alice Freire de Sousa
- Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes (CEPPAR). São Paulo, SP, Brasil
| | - Ilana Eshriqui
- Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes (CEPPAR). São Paulo, SP, Brasil
| | - Daiana Bonfim
- Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes (CEPPAR). São Paulo, SP, Brasil
| | - Leticia Yamawaka de Almeida
- Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes (CEPPAR). São Paulo, SP, Brasil
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de Oliveira DB, Rebustini F, Palacio DDC, Paresque MC, Oliveira IE, Barbieri W, Ribeiro DV, Heller D, Bomfim D, Tedesco TK. Validation of the internal structure of the Brazilian Dental Vulnerability Scale. Rev Saude Publica 2024; 57Suppl 3:8s. [PMID: 38629672 PMCID: PMC11037902 DOI: 10.11606/s1518-8787.2023057005360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/01/2023] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate evidence of validity of internal structure of the Brazilian Dental Vulnerability Scale (EVO-BR) when applied in Brazil. METHODS This is a psychometric study that seeks to validate a scale elaborated by evidence of internal structure. Data collection was conducted in 18 basic health units that implement the Brazilian Healthcare Planning (PAS) methodology, across the five regions of Brazil. The initial version of the EVO-BR contained 41 items that measured dental vulnerability and was applied to users of the Brazilian Unified Health System (SUS) aged 18 years or older who were in basic health units for consultation with higher education professionals. To evaluate the evidence, the following statistical analyses were performed: exploratory factor analysis, confirmatory factor analysis, and network analysis. RESULTS A total of 1,753 users participated in the study. To adjust the sample, we considered the factorability obtained from Kaiser-Meyer-Olkin (KMO) test = 0.65, Bartlett sphericity test = 8019.7, and a matrix determinant of 0.008. The initial parallel analysis indicated a four-dimensional model and had the items adjusted according to factor loading (ranging from 0.38 to 0.99), common factors (0.13 to 0.89), and Pratt's measure, until the model presented congruence in the statistical and interpretative principles simultaneously. The final model contained 15 items, maintaining the four dimensions indicated by the parallel analysis, and held an explained variance of 68.56%. CONCLUSIONS The EVO-BR is a validated scale to measure dental vulnerability and, thus, can contribute to the organization of access to the oral health team in primary health care (PHC) by stratifying the population, as recommended in the Brazilian Healthcare Planning.
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Affiliation(s)
- Daniele Boina de Oliveira
- Universidade Cruzeiro do SulDepartamento de OdontologiaSão PauloSPBrasilUniversidade Cruzeiro do Sul. Departamento de Odontologia. São Paulo, SP, Brasil
| | - Flávio Rebustini
- Universidade de São PauloEscola de Ciências, Humanidades e ArtesPrograma de Pós-graduação em GerontologiaSão PauloSPBrasilUniversidade de São Paulo. Escola de Ciências, Humanidades e Artes. Programa de Pós-graduação em Gerontologia. São Paulo, SP, Brasil
| | - Danielle da Costa Palacio
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesDiretoria de Atenção Primária à Saúde e Rede AssistencialSão PauloSPBrasilHospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. Diretoria de Atenção Primária à Saúde e Rede Assistencial. São Paulo, SP, Brasil
| | - Marcio Cardozo Paresque
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesDiretoria de Atenção Primária à Saúde e Rede AssistencialSão PauloSPBrasilHospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. Diretoria de Atenção Primária à Saúde e Rede Assistencial. São Paulo, SP, Brasil
| | - Ilana Eshriqui Oliveira
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesDiretoria de Atenção Primária à Saúde e Rede AssistencialSão PauloSPBrasilHospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. Diretoria de Atenção Primária à Saúde e Rede Assistencial. São Paulo, SP, Brasil
| | - Wander Barbieri
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesDiretoria de Atenção Primária à Saúde e Rede AssistencialSão PauloSPBrasilHospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. Diretoria de Atenção Primária à Saúde e Rede Assistencial. São Paulo, SP, Brasil
| | - Danielle Viana Ribeiro
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesDiretoria de Atenção Primária à Saúde e Rede AssistencialSão PauloSPBrasilHospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. Diretoria de Atenção Primária à Saúde e Rede Assistencial. São Paulo, SP, Brasil
| | - Debora Heller
- Universidade Cruzeiro do SulDepartamento de OdontologiaSão PauloSPBrasilUniversidade Cruzeiro do Sul. Departamento de Odontologia. São Paulo, SP, Brasil
| | - Daiana Bomfim
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesDiretoria de Atenção Primária à Saúde e Rede AssistencialSão PauloSPBrasilHospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. Diretoria de Atenção Primária à Saúde e Rede Assistencial. São Paulo, SP, Brasil
| | - Tamara Kerber Tedesco
- Universidade de São PauloFaculdade de OdontologiaDepartamento de Ortodontia e OdontopediatriaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Odontologia. Departamento de Ortodontia e Odontopediatria. São Paulo, SP, Brasil
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Zhu Z, Eli B, Chen Y, Liu Z. Symptom structure of posttraumatic stress disorder in workplace trauma: A "distraction-avoidance" pattern. J Clin Psychol 2024; 80:490-502. [PMID: 38050467 DOI: 10.1002/jclp.23626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 11/02/2023] [Accepted: 11/10/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Individuals who experience a workplace trauma are at a high risk of developing posttraumatic stress disorder (PTSD). Most of these people return to work soon after the trauma (i.e., experience early-stage natural exposure). This study aims to explore the response pattern of workers who have experienced a workplace trauma and early-stage natural exposure through network analysis and provide insights into the potential impact of early-stage natural exposure. METHODS Our study included 278 workers directly experiencing the workplace explosion in the Tianjin Economic and Technological Development Zone. A partial correlation network analysis was used to explore the PTSD symptoms relationship and identify central symptoms. RESULTS The results suggest that emotional numbness, difficulty in concentration, re-experiencing symptoms, and avoidance of thoughts are the most central symptoms, reflecting a "distraction-avoidance" pattern. CONCLUSIONS The current study found that workers who experienced workplace trauma exhibited a "distraction-avoidance" pattern, which helps deepen our understanding of the PTSD network and leads to some suggestions on intervention measures.
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Affiliation(s)
- Zhengqing Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Buzohre Eli
- Department of Psychology, Normal College, Shihezi University, Shihezi, Xinjiang, China
| | - Yaru Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Haws JK, Laifer LM, Acosta LM, Ralston AL, Ruggiero KJ, Davidson TM, Andrews AR. A Distinction Without a Difference? A Multi-Method Approach to Understanding PTSD and Depression Symptom Overlap Among Disaster-Exposed Adolescents. Res Child Adolesc Psychopathol 2023; 51:1021-1035. [PMID: 36881210 DOI: 10.1007/s10802-023-01042-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 03/08/2023]
Abstract
Among adolescents exposed to trauma, posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) commonly co-occur. Despite the prevalence of comorbidity, the question of how PTSD and MDD are related and appropriate conceptual models for understanding their linkage in adolescence remains unclear. This study applies a multi-methodological approach to advance conceptual and theoretical understanding of the overlap between PTSD and MDD diagnoses/symptoms. We tested three methodological approaches with three distinct theoretical underpinnings on the structure of each disorder proposed in the literature: confirmatory factor analysis (CFA) with dimensional constructs, latent class analysis (LCA) with person-based categorical constructs, and network analysis with symptom-to-symptom associations. Across the three different analytical approaches, there was a significant overlap between PTSD and MDD. Overall, there was no compelling evidence for distinct boundaries between disorders among trauma-exposed adolescents. Instead, we found considerable evidence that the typical latent-construct-based conceptualizations, whether categorical or dimensional, may need revision.
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Affiliation(s)
- James Kyle Haws
- Department of Family Medicine, and the Adult and Child Adult & Child Center for Outcomes Research & Delivery Science, University of Colorado School of Medicine, 13199 E. Montview Blvd, Suite 300, Aurora, CO, 80045, USA.
| | - Lauren M Laifer
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Laura M Acosta
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Allura L Ralston
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Kenneth J Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Tatiana M Davidson
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Arthur R Andrews
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
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Li Y, Guo Z, Tian W, Wang X, Dou W, Chen Y, Huang S, Ni S, Wang H, Wang C, Liu X, Zhu X, Wu S. An investigation of the relationships between suicidal ideation, psychache, and meaning in life using network analysis. BMC Psychiatry 2023; 23:257. [PMID: 37069569 PMCID: PMC10111716 DOI: 10.1186/s12888-023-04700-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/20/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Previous studies have investigated the relationships between psychache or meaning in life and suicidal ideation based on sum score of corresponding scale. However, this practice has hampered the fine-grained understanding of their relationships. This network analysis study aimed to conduct a dimension-level analysis of these constructs and the relationships among them in a joint framework, and identify potential intervention targets to address suicidal ideation. METHODS Suicidal ideation, psychache, and meaning in life were measured using self-rating scales among 738 adults. A network of suicidal ideation, psychache, and meaning in life was constructed to investigate the connections between dimensions and calculate the expected influence and bridge expected influence of each node. RESULTS "Psychache" was positively linked to "sleep" and "despair", while "presence of meaning in life" had negative associations with "psychache", "despair", and "pessimism". The most important central nodes were "sleep" and "despair", and the critical bridge nodes were "presence of meaning in life" and "psychache". CONCLUSION These preliminary findings uncover the pathological pathways underlying the relationships between psychache, meaning in life, and suicidal ideation. The central nodes and bridge nodes identified may be potential targets for effectively preventing and intervening against the development and maintenance of suicidal ideation.
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Affiliation(s)
- Yijun Li
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Wenqing Tian
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Xiuchao Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Weijia Dou
- Department of Gastroenterology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | | | - Shen Huang
- Xi'an Research Institute of High Technology, Xi'an, China
| | - Shengdong Ni
- School of Construction Machinery, Chang'an University, Xi'an, China
| | - Hui Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Chaoxian Wang
- The troops of Peoples's Liberation Army, Xi'an, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China.
- Air Force Medical University, No. 169 West Changle Road, Xi'an, Shaanxi Province, 710032, China.
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China.
- Air Force Medical University, No. 169 West Changle Road, Xi'an, Shaanxi Province, 710032, China.
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China.
- Air Force Medical University, No. 169 West Changle Road, Xi'an, Shaanxi Province, 710032, China.
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Guo Z, Yang T, He Y, Tian W, Wang C, Zhang Y, Liu J, Liu X, Zhu X, Wu S. The Relationships Between Suicidal Ideation, Meaning in Life, and Affect: a Network Analysis. Int J Ment Health Addict 2023:1-20. [PMID: 36776916 PMCID: PMC9904259 DOI: 10.1007/s11469-023-01019-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2023] [Indexed: 02/10/2023] Open
Abstract
Transitioning from holistic analysis to a fine-grained level analysis may provide further understanding of psychopathology. This study aimed to explore dimension-level relationships between suicidal ideation, meaning in life, and affect in a joint framework using network analysis and to identify potential prevention and intervention targets to address suicidal ideation. A total of 852 healthy adults aged 18-35 years completed self-report scales to assess suicidal ideation, meaning in life, and affect. A regularized partial correlation network was then built to examine the links between these dimensions. Expected influence and bridge expected influence values were calculated for each node. The prevalence of suicidal ideation was 4.2%. The search for and presence of meaning in life and positive and negative affect exhibited distinct and complex links to the three dimensions of suicidal ideation (pessimism, sleep, and despair). The important central nodes were search for meaning in life, sleep, despair, and positive affect, while the critical bridge nodes were positive affect, negative affect, and presence of meaning in life. These findings provide further understanding of the specific roles of meaning in life and affect in suicidal ideation. The identified nodes may be promising targets for prevention and intervention for suicidal ideation.
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Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Yang He
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Wenqing Tian
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Chaoxian Wang
- 94995 Troops of People’s Liberation Army, Beijing, China
| | - Yinling Zhang
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Jianjun Liu
- Outpatient Department, PLA Air Force 986 Hospital, Xi’an, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
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Guo Z, Yang T, Qiu R, Qiu H, Ren L, Liu X, Han Z, Zhu X. Network analysis of the relationships between problematic smartphone use and anxiety, and depression in a sample of Chinese college students. Front Psychiatry 2023; 14:1097301. [PMID: 37139318 PMCID: PMC10149733 DOI: 10.3389/fpsyt.2023.1097301] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/30/2023] [Indexed: 05/05/2023] Open
Abstract
Background Problematic smartphone use (PSU) is associated with both anxiety and depression. However, the relationships between components of PSU and symptoms of anxiety or depression have not been investigated. Hence, the aim of this study was to closely examine the relationships between PSU and anxiety and depression to identify the pathological mechanisms underpinning those relationships. A second aim was to identify important bridge nodes to identify potential targets for intervention. Methods Symptom-level network structures of PSU and anxiety, and PSU and depression were constructed to investigate the connections between the variables and evaluate the bridge expected influence (BEI) of each node. Network analysis using data from 325 Chinese healthy college students was performed. Results Five strongest edges appeared within the communities in both the PSU-anxiety and PSU-depression networks. The "Withdrawal" component had more connections with symptoms of anxiety or depression than any other PSU node. In particular, the edges between "Withdrawal" and "Restlessness" and between "Withdrawal" and "Concentration difficulties" were the strongest cross-community edges in the PSU-anxiety network and PSU-depression network, respectively. Furthermore, "Withdrawal" had the highest BEI in the PSU community in both networks. Conclusions These findings provide preliminary evidence of the pathological pathways linking PSU with anxiety and depression, with "Withdrawal" linking PSU with both anxiety and depression. Hence, "Withdrawal" may be a potential target for preventing and intervening in cases of anxiety or depression.
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Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Rui Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Huake Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Lei Ren
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Zheyi Han
- Department of Gastroenterology, Air Force Medical Center, Air Force Medical University, Beijing, China
- *Correspondence: Zheyi Han
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
- Xia Zhu
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Yang T, Guo Z, Cao X, Zhu X, Zhou Q, Li X, Wang H, Wang X, Wu L, Wu S, Liu X. Network analysis of anxiety and depression in the functionally impaired elderly. Front Public Health 2022; 10:1067646. [PMID: 36530716 PMCID: PMC9751796 DOI: 10.3389/fpubh.2022.1067646] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Background Evidence from previous studies has confirmed that functionally impaired elderly individuals are susceptible to comorbid anxiety and depression. Network theory holds that the comorbidity emerges from interactions between anxiety and depression symptoms. This study aimed to investigate the fine-grained relationships among anxiety and depression symptoms in the functionally impaired elderly and identify central and bridge symptoms to provide potential targets for intervention of these two comorbid disorders. Methods A total of 325 functionally impaired elderly individuals from five communities in Xi'an, China, were recruited for our investigation. The GAD-7 and PHQ-9 were used to measure anxiety and depression, respectively. SPSS 22.0 software was used for descriptive statistics, and R 4.1.1 software was used for network model construction, expected influence (EI) evaluation and bridge expected influence (BEI) evaluation. Results In the network, there were 35 edges (indicating partial correlations between symptoms) across the communities of anxiety and depression, among which the strongest edge was A1 "Nervousness or anxiety"-D2 "Depressed or sad mood." A2 "Uncontrollable worry" and D2 "Depressed or sad mood" had the highest EI values in the network, while A6 "Irritable" and D7 "Concentration difficulties" had the highest BEI values of their respective community. In the flow network, the strongest direct edge of D9 "Thoughts of death" was with D6 "Feeling of worthlessness." Conclusion Complex fine-grained relationships exist between anxiety and depression in functionally impaired elderly individuals. "Uncontrollable worry," "depressed or sad mood," "irritable" and "concentration difficulties" are identified as the potential targets for intervention of anxiety and depression. Our study emphasizes the necessity of suicide prevention for functionally impaired elderly individuals, and the symptom "feeling of worthlessness" can be used as an effective target.
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Affiliation(s)
- Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Xiaoqin Cao
- Xijing Hospital, Air Force Medical University, Shaanxi, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Qin Zhou
- Xijing Hospital, Air Force Medical University, Shaanxi, China
| | - Xinhong Li
- Tangdu Hospital, Air Force Medical University, Shaanxi, China
| | - Hui Wang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Xiuchao Wang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China,Shengjun Wu
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China,*Correspondence: Xufeng Liu
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Guo Z, He Y, Yang T, Ren L, Qiu R, Zhu X, Wu S. The roles of behavioral inhibition/activation systems and impulsivity in problematic smartphone use: A network analysis. Front Public Health 2022; 10:1014548. [PMID: 36339154 PMCID: PMC9627346 DOI: 10.3389/fpubh.2022.1014548] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/27/2022] [Indexed: 01/27/2023] Open
Abstract
Background Behavioral inhibition/activation systems (BIS/BAS) and impulsivity are associated with problematic smartphone use (PSU). However, no studies to date have explored how the subdomains of BIS/BAS and the dimensions of impulsivity relate to the components of PSU in a joint framework. This study aimed to examine the relationships between the three constructs at a fine-grained level and identify the central nodes and bridge nodes of their relationships using network analysis. Methods A regularized partial correlation network of PSU, BIS/BAS, and impulsivity communities was estimated to investigate the connections between variables and determine the expected influence and bridge expected influence for each variable based on data from 325 Chinese adults. PSU, BIS/BAS, and impulsivity were assessed using the Smartphone Application-Based Addiction Scale (SABAS), BIS/BAS scales, and Barratt Impulsiveness Scale-Version 11 (BIS-11), respectively. Results In addition to connections within each community, network analysis revealed that there were connections between different communities, especially connections to PSU. I2 "motor impulsivity" was strongly associated with PSU2 "conflict" and PSU6 "relapse"; BASR "BAS-reward responsiveness" was strongly associated with PSU5 "withdrawal." Nodes BASR "BAS-reward responsiveness" and PSU6 "relapse" were the most central variables, while nodes BASR "BAS-reward responsiveness" and I2 "motor impulsivity" were the strongest bridge variables. Conclusion The connections between the subdomains of BIS/BAS and the components of PSU and between the dimensions of impulsivity and the components of PSU may be particularly important in the development and maintenance of PSU. The central variables identified here, along with the bridge variables, could be promising and effective targets for the prevention and intervention of PSU.
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Guo Z, Liang S, Ren L, Yang T, Qiu R, He Y, Zhu X. Applying network analysis to understand the relationships between impulsivity and social media addiction and between impulsivity and problematic smartphone use. Front Psychiatry 2022; 13:993328. [PMID: 36329911 PMCID: PMC9623168 DOI: 10.3389/fpsyt.2022.993328] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Prior studies have revealed the relationships between impulsivity and social media addiction (SMA) and between impulsivity and problematic smartphone use (PSU) based on total scores on standardized self-report scales. However, there has been a lack of studies exploring how the dimensions of impulsivity and components of SMA or PSU are interrelated. The present study aimed to investigate the structural relationships between the dimensions of impulsivity and components of SMA and PSU and determine the critical bridge node using network analysis. METHODS A total of 325 healthy adults aged 18-36 years participated in the study. SMA and PSU were assessed using the Bergen Social Media Addiction Scale (BSMAS) and Smartphone Application-Based Addiction Scale (SABAS), respectively. Impulsivity was measured by the Barratt Impulsiveness Scale Version 11 (BIS-11). Network analysis was used to construct an SMA-Impulsivity network and a PSU-Impulsivity network. Bridge centrality (bridge expected influence, BEI) was estimated to identify influential bridge nodes. RESULTS In addition to relationships within each community, network analysis revealed that the dimensions of impulsivity were closely associated with the components of SMA and PSU. Particularly, I2 "motor impulsivity" had a relatively strong connection with SMA3 "mood modification" and SMA4 "relapse" in the SMA-Impulsivity network, and with PSU2 "conflict" and PSU5 "withdrawal" in the PSU-Impulsivity network. Moreover, I2 "motor impulsivity" was identified as the most critical bridge node in both networks. CONCLUSION These findings demonstrate potential pathways between different dimensions of impulsivity and the components of SMA and PSU, providing new evidence relevant to understanding the underlying mechanisms that account for how highly impulsive individuals develop SMA and PSU, and highlight the critical bridge node-motor impulsivity-that may be a promising and effective target for the prevention and treatment of SMA and PSU.
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Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Shuyi Liang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Lei Ren
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Rui Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Yang He
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
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Feng T, Ren L, Liu C, Li K, Wu L, Wei X, Yuan S, Cui LB, Yang X, Li D, Yang W, Li Y, Wang B, Wang H, Liu X. The relations between different components of intolerance of uncertainty and symptoms of depression during the COVID-19 pandemic: A network analysis. Front Psychiatry 2022; 13:993814. [PMID: 36311506 PMCID: PMC9613443 DOI: 10.3389/fpsyt.2022.993814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/09/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The relations between depression and intolerance of uncertainty (IU) have been extensively investigated during the COVID-19 pandemic. However, there is a lack of understanding on how each component of IU may differentially affect depression symptoms and vice versa. The current study used a network approach to reveal the component-to-symptom interplay between IU and depression and identify intervention targets for depression during the COVID-19 pandemic. METHODS A total of 624 college students participated in the current study. An IU-Depression network was estimated using items from the 12-item Intolerance of Uncertainty Scale and the Patient Health Questionnaire-9. We examined the network structure, node centrality, and node bridge centrality to identify component-to-symptom pathways, central nodes, and bridge nodes within the IU-Depression network. RESULTS Several distinct pathways (e.g., "Frustration when facing uncertainty" and "Feelings of worthlessness") emerged between IU and Depression. "Fatigue" and "Frustration when facing uncertainty" were identified as the central nodes in the estimated network. "Frustration when facing uncertainty," "Psychomotor agitation/retardation," and "Depressed or sad mood" were identified as bridging nodes between the IU and Depression communities. CONCLUSION By delineating specific pathways between IU and depression and highlighting the influential role of "Frustration when facing uncertainty" in maintaining the IU-Depression co-occurrence, current findings may inform targeted prevention and interventions for depression during the COVID-19 pandemic.
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Affiliation(s)
- Tingwei Feng
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Lei Ren
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Chang Liu
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Kuiliang Li
- School of Psychology, Army Medical University, Chongqing, China
| | - Lin Wu
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Xinyi Wei
- Department of Psychology, Renmin University of China, Beijing, China
| | - Shangqing Yuan
- School of Psychology, Capital Normal University, Beijing, China
| | - Long-Biao Cui
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Xi Yang
- Department of Health Economy Management, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Danyang Li
- College of Education Science, Changji University, Changji, China
| | - Wei Yang
- Psychological Counseling Center, Xijing University, Xi'an, China
| | - Ye Li
- Psychological Counseling Center, Xijing University, Xi'an, China
| | - Buyao Wang
- Clinical and Psychological Counseling, DongFang College, Beijing University of Chinese Medicine, Langfang, China
| | - Hui Wang
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Xufeng Liu
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
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