To do so, we compared differences between moment-to-moment time-lagged associations of pandemic-related cognitions, behaviors, and mental health, and tested for changes in centrality between lockdown stages. We set out to examine whether lockdown measures can alter the dynamic network structure of behavior (eg, physical activity) and pandemic-related mental states (eg, worry). Recently, a network approach to psychopathology proposed that changes in mental health result from a temporal dynamic interaction between mental states, such that one mental state at one moment in time (eg, worry) can trigger other mental states at the next moment in time (eg, feeling stressed). Reasons for this are an increase of distress or loneliness during the COVID-19 lockdown, yet most studies are overlooking the directionality between behavior and cognition over time. Together with the pandemic per se, these lockdown measures increased global mental health problems. To mitigate the spread of SARS-CoV-2, most countries enforced lockdown measures, including social restrictions, travel bans, stay-at-home orders, and business shutdown. The outbreak of COVID-19 is an unprecedented global health challenge as of November 2021, there are 259,502,031 confirmed cases and 5,183,003 deaths globally. Moreover, physical activity can serve as a buffer for loneliness amid social restrictions. Our study indicates that loneliness should be prioritized in mental health interventions during lockdown. Physical activity contributed to a decrease in loneliness amid the lockdown stage.Ĭonclusions: The COVID-19 lockdown increased the central role of loneliness in triggering stress-related behaviors and cognition. Moreover, during lockdown, the centrality of loneliness significantly increased. During lockdown, loneliness had the highest impact within the network, as indicated by its centrality index (ie, an index to identify variables that have a strong influence on the other variables). To compare network characteristics between a no-lockdown stage and a lockdown stage, we performed permutation tests. Results: We built a multilevel vector autoregressive model to estimate dynamic networks. Social activity was assessed on a 7-point Likert scale, while physical activity was recorded from wrist-worn actigraphy devices. COVID-19–related worry, information-seeking, perceived restriction, and loneliness were assessed by digital visual analog scales ranging from 0 to 100. A total of 258 participants who reported at least mild loneliness and distress were assessed 8 times a day for 7 consecutive days over a 213-day period from August 8, 2020, through March 9, 2021, in Germany, covering a “no-lockdown” and a “lockdown” stage. Methods: We combined ecological momentary assessments with wrist-worn motion tracking to investigate the mechanism and changes in network centrality of symptoms and behaviors before and during lockdown. This is the first study that compares network characteristics between lockdown stages to prioritize mental health intervention targets. Objective: We aimed to understand how a COVID-19 lockdown changes the temporal dynamics of loneliness and other factors affecting mental health. However, the temporal dynamics of causal factors that modulate mental health during lockdown are not well understood. JMIR Bioinformatics and Biotechnology 23 articlesĭepartment of Psychiatry and Neurosciencesīackground: The COVID-19 pandemic and its associated lockdown measures impacted mental health worldwide.JMIR Biomedical Engineering 61 articles.JMIR Perioperative Medicine 69 articles.Journal of Participatory Medicine 71 articles.JMIR Rehabilitation and Assistive Technologies 177 articles.
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