Prevalence and network structure of post-traumatic stress symptoms and their association with suicidality among Chinese mental health professionals immediately following the end of China's Dynamic Zero-COVID Policy: a national survey.

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    • Source:
      Publisher: Nature Pub. Group Country of Publication: United States NLM ID: 101562664 Publication Model: Electronic Cited Medium: Internet ISSN: 2158-3188 (Electronic) Linking ISSN: 21583188 NLM ISO Abbreviation: Transl Psychiatry Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York, NY : Nature Pub. Group
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    • Abstract:
      Studies on post-traumatic stress symptoms (PTSS) among mental health professionals (MHPs) are limited, particularly since restrictions due to coronavirus disease (COVID-19) have been lifted such as the recent termination of China's Dynamic Zero-COVID Policy. The current study filled this gap by exploring the prevalence, correlates, and network structure of PTSS as well as its association with suicidality from a network analysis perspective. A cross-sectional, national survey was conducted using a convenience sampling method on MHPs between January 22 and February 10, 2023. PTSS were assessed using the Post-Traumatic Stress Disorder Checklist-Civilian version, while suicidality was assessed using standardized questions related to ideation, plans, and attempts. Univariate and multivariate analyses examined correlates of PTSS. Network analysis explored the structure of PTSS and suicidality. The centrality index of "Expected influence" was used to identify the most central symptoms in the network, reflecting the relative importance of each node in the network. The "flow" function was adopted to identify specific symptoms that were directly associated with suicidality. A total of 10,647 MHPs were included. The overall rates of PTSS and suicidality were 6.7% (n = 715; 95% CI = 6.2-7.2%) and 7.7% (n = 821; 95% CI = 7.2-8.2%), respectively. Being married (OR = 1.523; P < 0.001), quarantine experience (OR = 1.288; P < 0.001), suicidality (OR = 3.750; P < 0.001) and more severe depressive symptoms (OR = 1.229; P < 0.001) were correlates of more PTSS. Additionally, higher economic status (e.g., good vs. poor: OR = 0.324; P = 0.001) and health status (e.g., good vs. poor: OR = 0.456; P < 0.001) were correlates of reduced PTSS. PCL6 ("Avoiding thoughts"; EI = 1.189), PCL7 ("Avoiding reminders"; EI = 1.157), and PCL11 ("Feeling emotionally numb"; EI = 1.074) had the highest centrality, while PCL12 ("Negative belief"), PCL 16 ("Hypervigilance") and PCL 14 ("Irritability") had the strongest direct, positive associations with suicidality. A high prevalence of lingering PTSS was found among MHPs immediately after China's "Dynamic Zero-COVID Policy" was terminated. Avoidance and hyper-arousal symptoms should be monitored among at-risk MHPs after the COVID-19 pandemic and serve as potential targets for the prevention and treatment of PTSS in this population.
      (© 2023. The Author(s).)
    • References:
      Stress Health. 2021 Oct;37(4):692-705. (PMID: 33434296)
      J Clin Psychol. 2019 Apr;75(4):644-663. (PMID: 30597543)
      Front Med (Lausanne). 2020 Jul 03;7:356. (PMID: 32719805)
      Behav Res Methods. 2018 Apr;50(2):853-861. (PMID: 28718088)
      J Child Psychol Psychiatry. 2019 Aug;60(8):897-906. (PMID: 30900257)
      Int J Nurs Pract. 2001 Apr;7(2):74-83. (PMID: 11811320)
      Suicide Life Threat Behav. 1994 Spring;24(1):58-67. (PMID: 8203009)
      J Child Psychol Psychiatry. 2019 May;60(5):545-554. (PMID: 30648742)
      BMC Psychiatry. 2021 Nov 15;21(1):572. (PMID: 34781901)
      Int J Biol Sci. 2020 Mar 15;16(10):1741-1744. (PMID: 32226293)
      Brain Behav Immun. 2020 Oct;89:531-542. (PMID: 32485289)
      J Trauma Stress. 2000 Jul;13(3):489-98. (PMID: 10948488)
      Asian J Psychiatr. 2022 Jun;72:103062. (PMID: 35339873)
      Dialogues Clin Neurosci. 2015 Jun;17(2):141-50. (PMID: 26246789)
      Psychol Methods. 2022 Apr 11;:. (PMID: 35404628)
      Int J Biol Sci. 2022 Aug 21;18(14):5317-5328. (PMID: 36147478)
      J Trauma Stress. 2005 Apr;18(2):165-70. (PMID: 16281210)
      Front Psychiatry. 2021 May 21;12:665507. (PMID: 34093279)
      Front Psychiatry. 2023 Feb 15;14:975443. (PMID: 36873200)
      Psychol Health Med. 2022 Feb;27(2):367-378. (PMID: 33906519)
      Int J Environ Res Public Health. 2021 Jan 12;18(2):. (PMID: 33445712)
      JAMA Netw Open. 2020 May 1;3(5):e2010185. (PMID: 32463467)
      Soc Sci Med. 2015 Jan;125:94-106. (PMID: 24128674)
      Heliyon. 2021 Jun 26;7(7):e07393. (PMID: 34278018)
      Int J Nurs Stud. 2007 Aug;44(6):991-8. (PMID: 16618485)
      BMJ Open. 2022 Jan 11;12(1):e047753. (PMID: 35017231)
      Clin Psychol Sci. 2018 May;6(3):335-351. (PMID: 29881651)
      Ann Clin Psychiatry. 2016 Aug;28(3):197-208. (PMID: 27490836)
      J Affect Disord. 2022 Dec 1;318:80-87. (PMID: 36030998)
      J Nerv Ment Dis. 2005 Jul;193(7):450-4. (PMID: 15985839)
      Psychol Health Med. 2022 Feb;27(2):444-452. (PMID: 34192997)
      Annu Rev Clin Psychol. 2013;9:91-121. (PMID: 23537483)
      J Trauma Dissociation. 2015;16(2):153-69. (PMID: 25587939)
      Hong Kong Med J. 2012 Aug;18 Suppl 3:24-7. (PMID: 22865219)
      Curr Opin Psychol. 2015 Oct 1;5:13-17. (PMID: 26086030)
      Psychiatry Res. 2020 Nov;293:113382. (PMID: 32829073)
      Behav Res Methods. 2018 Feb;50(1):195-212. (PMID: 28342071)
      China CDC Wkly. 2022 Jan 28;4(4):74-75. (PMID: 35186372)
      Curr Psychiatry Rep. 2019 Jun 26;21(7):61. (PMID: 31243637)
      Psychol Med. 2016 Dec;46(16):3359-3369. (PMID: 27623748)
      J Family Med Prim Care. 2020 Oct 30;9(10):5415-5418. (PMID: 33409238)
      J Clin Psychol. 2007 Sep;63(9):871-90. (PMID: 17674402)
      Int J Environ Res Public Health. 2020 Sep 24;17(19):. (PMID: 32987798)
      Psychol Trauma. 2023 Nov;15(8):1398-1405. (PMID: 35901423)
      J Trauma Stress. 2013 Jun;26(3):299-309. (PMID: 23696449)
      J Clin Psychiatry. 2000;61 Suppl 7:22-32. (PMID: 10795606)
      JMIR Public Health Surveill. 2020 Apr 27;6(2):e18576. (PMID: 32319956)
      J Affect Disord. 2020 Nov 1;276:312-315. (PMID: 32871661)
      Psychiatry Res. 2020 Oct;292:113312. (PMID: 32717711)
      Nat Commun. 2019 Apr 4;10(1):1529. (PMID: 30948709)
      Emerg Infect Dis. 2006 Dec;12(12):1924-32. (PMID: 17326946)
      Ann Med Surg (Lond). 2020 Dec;60:5-8. (PMID: 33072312)
      Psychol Trauma. 2020 Sep;12(6):572-575. (PMID: 32744843)
      Asian J Psychiatr. 2020 Dec;54:102300. (PMID: 32683251)
      Arch Suicide Res. 2010;14(1):1-23. (PMID: 20112140)
      Front Psychol. 2015 Mar 23;6:309. (PMID: 25852621)
      Asian J Psychiatr. 2023 Apr;82:103485. (PMID: 36731222)
      Ann Med Surg (Lond). 2020 Jun 14;56:38-42. (PMID: 32562476)
      Soc Psychiatry Psychiatr Epidemiol. 2015 Apr;50(4):525-37. (PMID: 25398198)
      Front Psychiatry. 2021 Apr 15;12:649989. (PMID: 33935836)
      Front Psychiatry. 2021 Jun 15;12:567381. (PMID: 34211406)
      J Psychosom Res. 2020 Dec;139:110270. (PMID: 33070044)
      Arch Gen Psychiatry. 1999 Jul;56(7):617-26. (PMID: 10401507)
      Can J Psychiatry. 2014 Sep;59(9):460-7. (PMID: 25565692)
      Int J Biol Sci. 2022 Aug 21;18(14):5314-5316. (PMID: 36147473)
      Lancet. 2020 Mar 14;395(10227):912-920. (PMID: 32112714)
      J Gen Intern Med. 2001 Sep;16(9):606-13. (PMID: 11556941)
      Front Public Health. 2021 Jan 21;8:620023. (PMID: 33553099)
      Epidemiol Infect. 2008 Jul;136(7):997-1007. (PMID: 17662167)
      J Abnorm Psychol. 2016 Aug;125(6):747-57. (PMID: 27505622)
      Lancet Digit Health. 2021 Feb;3(2):e76-e77. (PMID: 33509387)
      J Ment Health. 2021 Feb;30(1):1-2. (PMID: 32339041)
      J Psychiatr Res. 2021 Mar;135:256-263. (PMID: 33508545)
      J Clin Nurs. 2020 Nov;29(21-22):4321-4330. (PMID: 32860287)
      Presse Med. 2018 May;47(5):423-430. (PMID: 29580906)
      J Affect Disord. 2020 Sep 1;274:1-7. (PMID: 32405111)
    • Publication Date:
      Date Created: 20231215 Date Completed: 20231218 Latest Revision: 20231218
    • Publication Date:
      20231218
    • Accession Number:
      PMC10724192
    • Accession Number:
      10.1038/s41398-023-02680-3
    • Accession Number:
      38102131