COVID-19 Stress and the Persistent Shadow of Xenophobia: Results from a Network Analysis Study Across Two Large-Scale Independent Samples

Objective: The COVID-19 pandemic has impacted the mental health of more citizens than any other modern infectious outbreak. Emerging statistical methods like network analysis provide researchers with the ability to assess the relationship between pandemic-related cognitions and behaviours as the pandemic has progressed. The COVID Stress Scales (CSS) are a 36-item measure designed to assess the key symptoms of COVID stress, including worry about the dangerousness of the virus, fear of contamination, worry about socioeconomic ramifications, xenophobic fears, traumatic stress reactions, and checking and reassurance seeking. The purpose of the current study was to assess changes over time in the relationships between the symptoms (as network nodes) of COVID stress in two large independent North American samples (N1=6827; N2=5787) using network theory. Methods: Network estimation was conducted on a sample from early-mid 2020 and a sample from early-mid 2021, with follow-up analysis using the network comparison test. Results: Xenophobic fears were identified as a central node, with this finding replicated in the second independent sample. As the pandemic progressed, the relationship between any particular nodes in the COVID stress network was likely to become stronger, with consistent relationships between cognitive (e.g., rumination) and behavioural (e.g., reassurance-seeking) nodes. Conclusions: The current study is the first to use the network comparison test to assess changes in the relationships between symptoms of COVID stress across time points of the COVID-19 pandemic. Like previous infectious outbreaks in North America, xenophobic fears played a central role. Also, the role that cognitions and behaviours have in promoting stress related to contagion was represented in the networks. Carefully disseminating evidence-based information regarding contagion may reduce outbreak-related stress in future outbreaks that share similar characteristics with the COVID-19 pandemic.