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      Excessive Worrying as a Central Feature of Anxiety during the First COVID-19 Lockdown-Phase in Belgium: Insights from a Network Approach

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          Abstract

          Since the WHO declared the COVID-19 pandemic on March 11, 2020, the novel coronavirus, SARS-CoV-2, has profoundly impacted public health and the economy worldwide. But there are not the only ones to be hit. The COVID-19 pandemic has also substantially altered mental health, with anxiety symptoms being one of the most frequently reported problems. Especially, the number of people reporting anxiety symptoms increased significantly during the first lockdown-phase compared to similar data collected before the pandemic. Yet, most of these studies relied on a unitary approach to anxiety, wherein its different constitutive features (i.e., symptoms) were tallied into one sum-score, thus ignoring any possibility of interactions between them. Therefore, in this study, we seek to map the associations between the core features of anxiety during the first weeks of the first Belgian COVID-19 lockdown-phase ( n = 2,829). To do so, we implemented, in a preregistered fashion, two distinct computational network approaches: a Gaussian graphical model and a Bayesian network modelling approach to estimate a directed acyclic graph. Despite their varying assumptions, constraints, and computational methods to determine nodes (i.e., the variables) and edges (i.e., the relations between them), both approaches pointed to excessive worrying as a node playing an especially influential role in the network system of the anxiety features. Altogether, our findings offer novel data-driven clues for the ongoing field’s larger quest to examine, and eventually alleviate, the mental health consequences of the COVID-19 pandemic.

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          Most cited references117

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          Diagnostic and Statistical Manual of Mental Disorders

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            A brief measure for assessing generalized anxiety disorder: the GAD-7.

            Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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              The psychological impact of quarantine and how to reduce it: rapid review of the evidence

              Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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                Author and article information

                Contributors
                Journal
                Psychol Belg
                Psychol Belg
                2054-670X
                Psychologica Belgica
                Ubiquity Press
                0033-2879
                2054-670X
                30 December 2021
                2021
                : 61
                : 1
                : 401-418
                Affiliations
                [1 ]Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
                [2 ]Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
                [3 ]Neurology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
                [4 ]Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
                [5 ]Media Innovation & Intelligibility Lab, Université catholique de Louvain, Louvain-la-Neuve, Belgium
                [6 ]Language and Communication Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
                Author notes
                CORRESPONDING AUTHOR: Alexandre Heeren Psychological Sciences Research Institute, Université catholique de Louvain, 10 Place du Cardinal Mercier, 1348 Louvain-la-Neuve, Belgium alexandre.heeren@ 123456uclouvain.be
                Author information
                https://orcid.org/0000-0003-0553-6149
                https://orcid.org/0000-0002-3102-6778
                https://orcid.org/0000-0002-1209-7474
                https://orcid.org/0000-0002-9307-8880
                Article
                10.5334/pb.1069
                8719470
                35070347
                9db1d8b9-4275-4e73-bf99-9f1ace4ab26e
                Copyright: © 2021 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.

                History
                : 11 March 2021
                : 10 December 2021
                Funding
                Alexandre Heeren was supported by the F.R.S.-FNRS Belgian Science Foundation (Grant “1.C.059.18F”) and the Helaers Foundation for Medical Research. Alexandre Heeren is also supported by the Belgian Fund for Scientific Research (F.R.S.-FNRS, Belgium) as Research Associate. These foundations did not exert any editorial influence over this article. Grégoire Lits was supported by the Special Research Fund (FSR) of the Université catholique de Louvain as early career academic.
                Categories
                Research Article

                covid-19,anxiety,worry,gad,network approach to psychopathology,directed acyclic graph,gaussian graphical model,psychopathology,pandemic,lockdown

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