Network analysis of social support, resilience, quality of life, and insomnia under pandemic control measures.

The network showed negative associations between insomnia symptoms and social support, resilience, and quality of life.

• 662 participants were recruited between April and May 2022 during COVID-19 pandemic control measures.
• Participants completed four validated scales: Social Support Rating Scale (SSRS), Connor-Davidson Resilience Scale (CD-RISC), World Health Organization Quality of Life-Brief (WHOQOL-BREF), and Athens Insomnia Scale (AIS).
• Network models were constructed with dimensions of each scale and individual insomnia symptoms as nodes.
• Centrality metrics computed included strength, expected influence, and bridge expected influence (BEI).

Psychological quality of life (Q2) and resilience strength (R2) had the highest strength and high expected influence in the network.

• Q2 (psychological domain of quality of life) demonstrated the highest strength centrality among all nodes.
• R2 (strength dimension of resilience) also showed the highest strength and high expected influence.
• These two nodes were identified as core nodes within the overall network.
• High strength centrality indicates these nodes had the most connections and strongest overall associations with other nodes in the network.

R1 (tenacity), Q2 (psychological quality of life), and S1 (objective social support) demonstrated the greatest positive bridge expected influence in the network.

• Bridge expected influence (BEI) was used to identify nodes that serve as connectors between different communities (social support, resilience, quality of life, and insomnia symptoms).
• R1 (tenacity dimension of resilience) had the greatest positive BEI, indicating it serves as a key connector between resilience and other communities.
• Q2 (psychological quality of life) showed high positive BEI in addition to being a core node by strength.
• S1 (objective support dimension of social support) also demonstrated high positive BEI, suggesting objective social support connects social support to other network communities.

I6 (sense of well-being during the day) had the greatest negative bridge expected influence within the insomnia symptom community.

• I6 is a daytime functioning item from the Athens Insomnia Scale (AIS) representing sense of well-being during the day.
• Its negative BEI indicates it served as a bridge symptom connecting insomnia to the other communities (social support, resilience, quality of life) in a negative direction.
• This suggests daytime well-being may be a key symptom linking insomnia to broader psychological and social functioning.
• The authors recommend clinicians prioritize interventions targeting bridge symptoms like I6 to enhance treatment effectiveness.

The study identified core and bridge nodes that provide a theoretical foundation for targeting interventions to improve population mental health and sleep quality during prolonged pandemic control measures.

• Network analysis methodology allowed identification of both highly central nodes (core nodes) and nodes connecting different communities (bridge nodes).
• The authors recommend prioritizing interventions that target core nodes and bridge symptoms.
• The study was conducted specifically in the context of prolonged pandemic control measures (April–May 2022).
• The complex interrelationships among social support, resilience, quality of life, and insomnia were illuminated through the network approach, which the authors note was insufficiently understood previously.