The network structure of psychopathological and resilient responses to the coronavirus pandemic: A multi-country study of general population depression and anxiety symptoms

Abstract Commonly identified trajectories of psychological distress in response to adverse events, like the COVID-19 pandemic, include Resilience, Delayed distress, Recovery and Sustained distress. The current study aimed to analyse these four distinct response patterns during the pandemic using network analysis. Anxiety and depression symptom data collected across four European countries over the first year of the pandemic were analysed (N = 3594). Participants were firstly categorised into one of the four aforementioned response patterns. Networks of symptoms were then estimated in each of these groups, and they were compared in relation to network connectivity and symptom clustering. Informed by network theory, it was hypothesised that greater levels of resiliency would be characterised by lower symptom connectivity and fewer symptom clusters. Two-thirds (64%) of the sample were categorised as displaying a pattern of Resilience. The connectivity hypothesis was partially supported: the Sustained distress group show higher connectivity than the Recovered group; however, the Resilient group showed higher connectivity than the Delayed distress group. Regarding symptom clustering, non-random clusters were identified in the Recovered and Sustained groups only, and, in contrast to the initial hypotheses, more clusters emerged in the Recovered group (three) than in the Sustained distress group (two). Our results replicated findings that resilience was the most common mental health pattern over the first year of the pandemic. Moreover, they suggested that high network connectivity may be indicative of a stable mental health response over time, whereas fewer symptom clusters may be indicative of a pattern of sustained distress. Although exploratory, the network perspective provided a useful tool to examine the complexity of patterns of psychological responses to adverse events, and if replicated, could be used to help identify indicators of protection against, or vulnerability to, psychological distress in future.