The network and interactive pattern of social adjustment and psychological symptoms in patients with spinal cord injury: a network analysis.

BACKGROUND

The network approach offers a novel framework for conceptualizing depression, anxiety and social adaptability as causal systems, which helps in understanding what may be relevant targets for treatment.

OBJECTIVE

To determine the network structure and interaction patterns of social adjustment and psychological symptoms in patients with spinal cord injury (SCI).

METHODS

A cross-sectional patient-reported study was conducted using an online questionnaire survey disseminated from February to April 2023. The survey included the Medical Coping Modality Questionnaire (MCMQ), Social Support Rate Scale (SSRS), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). A total of 251 questionnaires were completed. Graphical lasso networks and directed acyclic graphs (DAGs) were used to visualize and analyze the associations between symptom levels corresponding to the four scales.

RESULTS

The average age of patients with SCI was 54.96 years, and 61.4% were male. Network analysis revealed that "concentration" in depression symptoms and "trouble relaxing" in anxiety symptoms had the greatest centrality strength. The anxiety symptom "nervousness" and depression symptom "failure" exhibited the greatest bridge strength. The results of the directed acyclic graph indicated a key triggering role for "nervousness" symptoms.

CONCLUSION

"Concentration" of depression symptoms and "trouble relaxation" of anxiety symptoms play key roles in the psychological and social adjustment of patients with SCI. It is essential to pay attention to "nervousness", as it is at the upper end of the symptom response cascade.