The relationship between irritability, depression and anxiety among Chinese college students during the COVID-19 pandemic: A network analysis

Abstract

IntroductionIrritability, a common symptom included in the 5th Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is thought to be associated with multiple emotional disorders. It is commonly seen among college students in isolation during the COVID-19 pandemic. However, its relation with anxiety and depression remains unclear. We aim to study the relation of irritability, anxiety and depression in Chinese college students during the COVID-19 pandemic by using network analysis to understand the co-occurrence of these three disorders.MethodsDuring the COVID-19 pandemic, we recruited 1516 college students from five general universities in China to complete the Irritability, Depression and Anxiety Scale (IDA-S) to analyze the symptom network of irritability, depression and anxiety. Specifically, we assessed the indices of strength centrality and bridge strength for each node in the network.ResultsSome strongest linkages were found among anxiety symptoms “nervous” and “panic” (weight = 0.36), depression symptoms “sad mood” and “amused” (weight = 0.32), inward irritability items “self-hurt” and “self-harm” (weight = 0.32) and outward items “rough” and “aggressive” (weight = 0.28). The anxiety symptom “panic” had the highest strength value, followed by the inward irritability symptom “annoyed”. The nodes “ease” and “sleep” had the lowest strength value. In addition, the anxiety symptom “relax” had the highest bridge strength value, followed by inward irritability symptom “annoyed”.ConclusionThis study explored the characteristics of a network of irritability, depression and anxiety symptoms among Chinese college students during the COVID-19 pandemic. We found that anxiety and irritability symptoms played an important role in the network. The findings provide evidence for prevention and intervention for college students' mental health problems during the COVID-19 pandemic.

How are irritability and anhedonia symptoms linked? A network approach

“…Bai et al (2021) found that irritability was the most central symptom among nursing students during the COVID-19 pandemic, and anhedonia was identified as a bridge symptom linking depressive and anxiety (including irritability) symptoms. Li et al (2023) demonstrated that the inward irritability symptom "annoyed" had the second highest strength in the network in a sample of Chinese college students during COVID-19 pandemic, indicating that it was closely connected to others anxiety and depression (including anhedonia) symptoms. Garabiles et al (2019) also showed that irritability was more strongly connected to anhedonia and fatigue than any other depressive or anxiety symptoms in a sample of migrant domestic workers, a population vulnerable to depression and anxiety disorders (Hall et al, 2019;Lindert et al, 2009).…”

The relationship between self-control and mental health problems among Chinese university students

“…The impact of irritability on adults is often overlooked by researchers, and in the DSM-5, irritability is defined as a cross-diagnostic symptom, involving multiple psychiatric disorders such as depression and anxiety (16). Research on the relationship between irritability and anxiety and depression yielded inconsistent results (17), with network analysis results demonstrating a co-morbid relationship between irritability, anxiety, and depressive symptoms, as well as their separation relationship (18). In particular, university students are more likely to exhibit irritability symptoms when depressed or anxious (19).…”

“…As the mental health of university students during the COVID-19 epidemic is not promising, self-control training during isolation may need to be developed to help improve their mental health. Given irritability and anxiety symptoms play a more important role in the irritability, depression, and anxiety network compared with depressive symptoms (18), this study aimed to explore the bridging connections of self-control abilities with irritability, depression, and anxiety symptoms, respectively, through a network analysis approach. We hypothesized that (1) self-control is negatively correlated with irritability, depression, and anxiety symptoms; and (2) self-control is consistent with bridge symptoms in the irritability and anxiety networks while inconsistent in the depression network.…”