Psychological Networks can Identify Potential Pathways to Specific Intervention Targets for Anxiety in Response to Coronavirus Disease 2019 (COVID-19)

Addressing mental health challenges related to the COVID-19 outbreak can be facilitated through research that characterizes the needs of subpopulations and identifies specific pathways to targeted intervention. Toward this aim, we examined the impact of the COVID-19 outbreak on anxiety symptoms among college students (N = 487) and explored the relative impact of coping strategies using a psychological network approach, which models complex interactions to identify potential pathways to symptom-level intervention. Although students showed several significant fluctuations in pre- to post-outbreak anxiety symptom levels measured with the GAD-7, anxiety network connectivity was not significantly different across timepoints. Consistent with hypotheses, the post-outbreak symptom+coping network revealed that increased use of the adaptive coping strategies of acceptance, behavioral activation, and values-based action was associated with lower levels of fear, restlessness, and trouble relaxing. The symptom+coping network also revealed that increased use of the maladaptive strategies of excessive cleaning, reassurance seeking, and excessive checking was associated with higher levels of irritability and fear. Surprisingly, the use of reappraisal and avoidance, two strategies with putatively opposing adaptive value, highly overlapped and showed positive associations with fear and irritability. These symptom+coping associations can guide the assessment and treatment of anxiety in the face of COVID-19.