Prevalence and network structure of post-traumatic stress symptoms and their association with suicidality among Chinese mental health professionals immediately following the end of China's Dynamic Zero-COVID Policy: a national survey

Studies on post-traumatic stress symptoms (PTSS) among mental health professionals (MHPs) are limited, particularly since COVID-19 restrictions were lifted following termination of China’s Dynamic Zero-COVID Policy. This national cross-sectional survey (January 22–February 10, 2023) examined prevalence, correlates, and the PTSS network structure, and its association with suicidality. PTSS were measured with the Post-Traumatic Stress Disorder Checklist-Civilian version (PCL-C); suicidality was assessed via standardized questions on ideation, plan, and attempt. Univariate/multivariate analyses identified correlates; network analysis identified central symptoms (expected influence) and direct links to suicidality (flow function). Among 10,647 MHPs, prevalence of PTSS and suicidality were 6.7% (95% CI 6.2–7.2%) and 7.7% (95% CI 7.2–8.2%), respectively. Correlates of higher PTSS included being married (OR=1.523), quarantine experience (OR=1.288), suicidality (OR=3.750), and more severe depression (PHQ-9 OR=1.229 per point). Better economic (good vs poor OR=0.324) and health status (good vs poor OR=0.456) correlated with lower PTSS. Most central symptoms were Avoiding thoughts (PCL6), Avoiding reminders (PCL7), and Feeling emotionally numb (PCL11). Symptoms most directly associated with suicidality were Negative beliefs (PCL12), Hypervigilance (PCL16), and Irritability (PCL14). Findings suggest lingering PTSS among MHPs post-policy termination; avoidance and hyperarousal symptoms may be key monitoring and intervention targets.

Pan Chen, Ling Zhang, Yuan Feng, Feng-Rong An, Zhaohui Su, Teris Cheung, Ka-In Lok, Gabor S. Ungvari, Todd Jackson, Yu-Tao Xiang, Qinge Zhang