The mechanisms for maintenance of COVID Stress Syndrome symptom networks: a dynamic network analysis

BACKGROUND AND OBJECTIVES: COVID Stress Syndrome (CSS) is a new type of health anxiety triggered by the COVID epidemic. However, we know little about the causal relationship with CSS symptoms and the temporal and dynamic interactions between symptoms and cognitive processes associated with health anxiety. DESIGN: During the epidemic of COVID-19, 193 Chinese university students completed experience sampling methods on CSS symptoms and related constructs of health anxiety three times a day for 14 days. METHODS: Multilevel vector autoregressive (mlVAR) models were used to estimate contemporaneous and temporal networks at the within-person level. RESULTS: (1) The CSS symptoms were divided into two periods of growth and maintenance during these 14 days. (2) The COVID-19 traumatic stress dimension played a crucial role in maintaining the symptom network. (3) Catastrophizing of bodily sensations and rumination formed a positive feedback loop with COVID traumatic stress symptoms dimension of the CSS. CONCLUSION: This study advances the current understanding of CSS at the symptom level and temporal dynamics. The results suggest that the COVID traumatic stress dimension is a core mechanism for CSS maintenance and could be a point of focus for intervention and treatment in clinical practice.