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新冠疫情大流行期间抑郁症状及相关心理病理过程的日内和日间相互作用模式:动态网络方法。

Within- and across-day patterns of interplay between depressive symptoms and related psychopathological processes: a dynamic network approach during the COVID-19 pandemic.

机构信息

Department of Psychology, University of Oslo, Oslo, Norway.

Modum Bad Psychiatric Hospital and Research Center, Vikersund, Norway.

出版信息

BMC Med. 2021 Nov 30;19(1):317. doi: 10.1186/s12916-021-02179-y.

Abstract

BACKGROUND

In order to understand the intricate patterns of interplay connected to the formation and maintenance of depressive symptomatology, repeated measures investigations focusing on within-person relationships between psychopathological mechanisms and depressive components are required.

METHODS

This large-scale preregistered intensive longitudinal study conducted 68,240 observations of 1706 individuals in the general adult population across a 40-day period during the COVID-19 pandemic to identify the detrimental processes involved in depressive states. Daily responses were modeled using multi-level dynamic network analysis to investigate the temporal associations across days, in addition to contemporaneous relationships between depressive components within a daily window.

RESULTS

Among the investigated psychopathological mechanisms, helplessness predicted the strongest across-day influence on depressive symptoms, while emotion regulation difficulties displayed more proximal interactions with symptomatology. Helplessness was further involved in the amplification of other theorized psychopathological mechanisms including rumination, the latter of which to a greater extent was susceptible toward being influenced rather than temporally influencing other components of depressive states. Distinctive symptoms of depression behaved differently, with depressed mood and anhedonia most prone to being impacted, while lethargy and worthlessness were more strongly associated with outgoing activity in the network.

CONCLUSIONS

The main mechanism predicting the amplifications of detrimental symptomatology was helplessness. Lethargy and worthlessness revealed greater within-person carry-over effects across days, providing preliminary indications that these symptoms may be more strongly associated with pushing individuals toward prolonged depressive state experiences. The psychopathological processes of rumination, helplessness, and emotion regulation only exhibited interactions with the depressed mood and worthlessness component of depression, being unrelated to lethargy and anhedonia. The findings have implications for the impediment of depressive symptomatology during and beyond the pandemic period. They further outline the gaps in the literature concerning the identification of psychopathological processes intertwined with lethargy and anhedonia on the within-person level.

摘要

背景

为了理解与抑郁症状形成和维持相关的错综复杂的相互作用模式,需要进行重复测量研究,重点关注心理病理机制与抑郁成分之间的个体内关系。

方法

本大规模的预先注册的密集纵向研究在 COVID-19 大流行期间的 40 天内对普通成年人群中的 1706 人进行了 68240 次观察,以确定涉及抑郁状态的有害过程。使用多层次动态网络分析对每日反应进行建模,以研究日间的时间关联,以及在每日窗口内抑郁成分之间的同期关系。

结果

在所研究的心理病理机制中,无助感对抑郁症状的跨日影响最强,而情绪调节困难与症状学的近期关系更为密切。无助感进一步涉及到包括反刍在内的其他理论化心理病理机制的放大,后者更容易受到影响,而不是在时间上影响抑郁状态的其他成分。不同的抑郁症状表现不同,情绪低落和快感缺失最容易受到影响,而疲劳和无价值感与网络中的外向活动的关联更为密切。

结论

预测有害症状放大的主要机制是无助感。疲劳和无价值感在个体内的跨日传递效应更大,初步表明这些症状可能与促使个体经历更长时间的抑郁状态体验的关联更强。反刍、无助感和情绪调节的心理病理过程仅与抑郁情绪和无价值感成分相互作用,与疲劳和快感缺失无关。这些发现对大流行期间和之后的抑郁症状的阻碍具有意义。它们进一步阐明了文献中关于在个体水平上识别与疲劳和快感缺失交织在一起的心理病理过程的差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5d7/8630884/dcf8c69b8071/12916_2021_2179_Fig1_HTML.jpg

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