This study explores internal linkages among depressive, anxiety, and acute stress symptoms in 2021 Henan floods victims during the disaster. Moreover, the interaction between instant flood exposure (IFE) and symptoms were testified. We conducted a survey from July 20 to August 6, 2021, when floods occurred in Henan. We employ convenience sampling to capture the immediate reaction of those (N = 714) exposed to the floods. We use self-reported survey answers to assess IFE and depressive, anxiety, and acute stress symptoms. We adopt a psychological network approach to analyze the internal linkages among symptoms and linkages between IFE and symptoms. Results revealed that: First, the strongest relationship between symptoms within each network model remains stable irrespective of whether we control for IFE; however, the strongest edge within depressive symptom cluster differs between the depression network and the depressive-anxiety-acute stress symptom cluster network. The order of central symptoms for depressive symptom cluster, anxiety symptom cluster, and acute stress symptom cluster changes after controlling for IFE. Second, the bridge symptoms of depressive-anxiety-acute stress symptom cluster network remain stable regardless of whether we control for IFE. However, the bridge symptoms of the depressive and acute stress symptoms network vary after controlling for IFE. Third, IFE related to changes in living and family conditions is a crucial factor in linking depressive, anxiety, and acute stress symptoms. Inconsistent results between depressive, anxiety, and acute stress symptom cluster networks and depressive-anxiety-acute stress symptom cluster network reveal that studies employing a network approach should control for potential confounders to avoid omitted variable bias. Sequential psychiatric reactions toward IFE during a disaster imply that pre-disaster community cohesion is crucial for positive coping during the disaster.

本研究探讨了 2021 年河南洪水灾民的抑郁、焦虑和急性应激症状之间的内在联系。此外，还证实了即时洪水暴露（IFE）与症状之间的相互作用。我们于2021年7月20日至8月6日河南发生洪涝灾害期间进行了调查。我们采用方便抽样来捕捉那些遭受洪水影响的人（N = 714）的立即反应。我们使用自我报告的调查答案来评估 IFE 以及抑郁、焦虑和急性应激症状。我们采用心理网络方法来分析症状之间的内部联系以及IFE与症状之间的联系。结果显示：首先，无论我们是否控制 IFE，每个网络模型中症状之间最强的关系都保持稳定；然而，抑郁症状群中最强的边缘在抑郁网络和抑郁-焦虑-急性应激症状群网络之间是不同的。控制 IFE 后，抑郁症状群、焦虑症状群和急性应激症状群的中心症状顺序发生变化。其次，无论我们是否控制 IFE，抑郁-焦虑-急性应激症状簇网络的桥接症状都保持稳定。然而，在控制 IFE 后，抑郁和急性应激症状网络的桥接症状有所不同。第三，与生活和家庭条件变化相关的IFE是将抑郁、焦虑和急性应激症状联系起来的关键因素。抑郁、焦虑和急性应激症状聚类网络与抑郁-焦虑-急性应激症状聚类网络之间的结果不一致表明，采用网络方法的研究应控制潜在的混杂因素，以避免遗漏变量偏差。灾难期间对 IFE 的连续精神病学反应表明，灾前社区凝聚力对于灾难期间的积极应对至关重要。