Information Sources and Their Relationship to Depressive and Anxiety Symptoms During the COVID-19 Pandemic: A Network Study

Research Question 1:

How central are different sources of information used to obtain knowledge about the COVID-19
pandemic in network along with depressive and anxiety symptoms? Which sources of information
are most strongly connected to different symptoms of depression and anxiety?

Staying away from information will be measured in the present study. As avoidance is a type
of safety behavior in anxiety disorders, the investigators are further eager to investigate
the centrality of this behavior in the network. Furthermore, multiple studies using
latent-variable paradigms have established a relationship between sum-scores of depression
and social anxiety use in general. The investigators are further interested in examining this
potential link more thoroughly and detailed in the present network study. The findings of
this study, although they will be cross-sectional and require further examination in studies
with temporal data structure, will be an important and interesting starting point giving
initial ideas about potential mechanisms that may be involved in use of information sources
in pandemics and mental health.

Statistical analysis:

The estimated network will consist of 23 items (9: PHQ-9; 7: GAD-7; 7: information sources to
obtain information about COVID-19). The network will be estimated using the R package qgraph
(Epskamp et al., 2012). Network stability and accuracy tests will be conducted using R
package bootnet (Epskamp, et al., 2018). An undirected partial correlation network will be
estimated, resulting in associations between each pair of symptoms controlling for all other
associations among symptoms. Centrality indices will be reported. The appropriate correlation
method will be applied following an assessment of the data (e.g., with regards to possible
skewness).

The network will further be regularized using Graphical Least Absolute Shrinkage and
Selection Operator (GLASSO), with Extended Bayes Information Criterion (EBIC). The tuning
parameter will be set to 0.5, as is recommended practice. Centrality table and plots will be
depicted, and difference test of edges conducted.

Additionally, the investigators will investigate differences in network structure across
major demographic subgroups in the sample (e.g., gender). All analyses and questions
addressed in the forthcoming paper that are not pre-specified in this pre-registered protocol
will be defined as exploratory.

The sources of information include: 1) National television and radio channels; 2) national
and regional, and local newspapers; 3) Use of social media for information; 4) use of blogs,
podcasts, forums or other Internet sources; 5) information obtained from peers (i.e., friends
and family); 6) Other sources of information; 7) actively staying away from information.

Inference criteria:

p < 0.05 to determine significance.

Sample size and power calculation:

Following power analysis guidelines by Fried & Cramer (2017), it is recommended that the
number of participants are three times larger than the number of estimated parameters.
However, more conservative recommendations by Roscoe (1975) for multivariate research,
recommends sample size that is ten times larger than the number of estimated parameters. The
network to be constructed for this study consists of 7 anxiety items (GAD-7), 9 depression
symptom items (PHQ-9), and the 7 pre-specified items above concerning medium of information
and extent of use. Consequently, the network consists of 23 items. 23x(23-1)/2 x 3 = at least
759 participants (according to guidelines by Fried & Cramer, 2017). Thus, following these two
approaches respectively, between 759 to 2530 participants are required. Data will be
collected for three weeks, and participants are based on a representative sample of Norwegian
adults with equal opportunity to partake in the study following providing digital consent.

Missing data:

The TSD system (Services for Sensitive Data), a platform used in Norway to store
person-sensitive data verifies participants officially through a kind of national ID number
to give them full right to withdraw their data at any time, following the European GDPR
(General Data Protection Regulation) laws. Accordingly, participants are allowed to withdraw
their own data at any time. The survey includes mandatory fields of response. Participation
is voluntarily, and withdrawal of any provided data is possible at any moment. The
investigators do not expect participants to withdraw their data and thus expect no missing
data. However, if participants do withdraw their data, the investigators will conduct
state-of-art missing data analysis and investigate whether data is missing at random.