(PS2-C64) Differential Impacts of Stressful Life Events on Symptoms of Depression and Anxiety: Symptom Network Analysis of a Multi-country Dataset

Background: Although it is well-established that experiencing stressful life events (SLEs) is associated with the increased level of symptoms of depression and anxiety and even directly triggers the onset of mental disorders, SLE is the collective term of multiple specific events, and symptoms of depression and anxiety include distinct sub-symptoms.

Aims: To explore the complex relationship between SLEs and symptoms of depression and anxiety among individuals with differential levels of SLE, we used the symptom profile approach and symptom network analysis and aimed to 1) validate the general relationship between SLEs and symptoms of depression and anxiety; 2) quantify the effect of experiencing SLEs on distinct negative mood symptoms; 3) estimate symptom network structure by using both global and local measures.

Methods: We performed a secondary analysis of a multi-country dataset (N=1754, M=34.33 years, 45% female) with a diverse cultural background, and the Depression, Anxiety, and Stress Scale, version 21 (DASS-21) and Traumatic Life Experiences Inventory (TLEI) scores were used for analysis.

Results: There was a positive correlation between SLEs and negative mood symptoms. Participants were divided into High vs. Low SLE group based on TLEI scores. Symptom profile analysis revealed unequal effects of SLE on individual negative mood symptoms by comparing each symptom item in the High vs. Low SLE groups, where touchiness was affected by SLE the most (d=.53), while 5 items in DASS-21 were not statistically significant. The negative mood symptom networks in High and Low SLE groups differed in their connectivity patterns. Global network efficiency didn’t show difference between the two groups (efficiency_high=.17; efficiency_low =.15, p >.05). For local degree centrality, anhedonia correlated with more items in the symptom network of the Low SLE group compared to that of the High SLE group (degree_low=6, degree_high=1, p=.002). Conversely, nervous arousal was correlated with more items in the symptom network of the High SLE group (degree_low=6, degree_high=1, p< .001).
Limitations: Only the type of SLEs was assessed in the TLEI, but the severity level of SLEs experienced by participants was unknown in the dataset. There had been limited evidence regarding the reliability and validity of TLEI as it was an adapted assessment.

Conclusion: Our findings demonstrated the distinct inter-correlation of negative mood symptoms among participants experiencing different levels of SLEs. This might shed light on potential direction in interventions for psychological disorders by targeting the hub symptoms in the future.