The psychological impact of the COVID-19 epidemic on college students in China

Psychological Help-Seeking Among College Students: Applying the Multi-Theory Model of Health Behavior Change in Assessing Telehealth Use for Psychological Help-Seeking

Background

Due to the deleterious effects on psychological health and wellbeing spurred by the pandemic, utilization of telehealth-based care increased over the past few years. The rapid transition from in-person to telehealth-based health service delivery has yet to be fully understood. The aim of the current study was to examine telehealth use for psychological help-seeking among college students using the Multi-theory Model of health behavior change (MTM) as a theoretical framework.

Methods

A cross-sectional and survey-based study was conducted among students at a large US university (N = 356). Valid and reliable scales were used to measure domains of psychological distress and MTM constructs. Participants were grouped based on past 12-month utilization of telehealth for any mental, emotional, or substance use problems.

Results

Roughly 67% of the sample reported that they needed help dealing with psychological distress, and 56.1%,43.3%, and 38.7% screened positive for anxiety, depression, and suicidal ideation, respectively. Depression, anxiety, and suicidal ideation were positively associated with past 12-month telehealth-based help-seeking. Past 12-month telehealth users reported greater advantages, confidence, and emotion direction toward telehealth-based psychological help-seeking than their counterparts. Participants also perceived higher exhibition of behavioral skills and greater social support to aid help-seeking than their counterparts. Advantages and disadvantages as well as behavioral confidence predicted intentions for telehealth-based help-seeking after controlling for anxiety, depression, suicidal ideation, perceived stigma, and perceived need for help among both groups.

Conclusion

The MTM theoretical framework is a valuable framework for predicting telehealth-based psychological help-seeking among college students. Such framework can be used to design and implement mental health programing.

The mediating role of behavioral systems in linking physical activity and anxiety symptoms in college students

Data show that the detection rate of anxiety symptoms among college students has risen from 16.6 to 34.8% over the past 10 years, and that college students are gradually becoming a high prevalence group for anxiety symptoms.This study aims to investigate the relationship between physical activity, behavioral inhibition and activation, and anxiety symptoms in college students. Specifically, it seeks to identify the mediating role of individual subcomponents of behavioral inhibition and activation in the association between physical activity and anxiety symptoms. A total of 5125 college students were recruited to participate in the study. Participants completed the Physical Activity Rating Scale-3, the Behavioral Inhibition/Activation System Scale, and the Generalized Anxiety Disorder-7 (GAD-7) scale. ANOVA, linear regression analysis and structural equation modelling were used to analyse the data and subcomponents of each variable (physical activity, anxiety symptoms, BIS/BAS) were analysed. Anxious college students demonstrated significantly lower scores in reward responsiveness, drive, and fun seeking, while exhibiting higher scores in behavioral inhibition. Additionally, these students engaged in physical activity at lower intensities, for shorter times, with reduced frequency, and overall less total exercise (all p < 0.001). Furthermore, a significant negative correlation was observed between levels of physical activity and anxiety (r= - 0.145, p < 0.001), while a weak correlation was identified between physical activity levels and the behavioral inhibition system (r= - 0.020, p = 0.156). Conversely, physical activity levels were significantly positively correlated with the behavioral activation subcomponents of reward responsiveness (r = 0.062, p < 0.001), drive (r = 0.122, p < 0.001), and fun seeking (r = 0.067, p < 0.001). Physical activity, behavioral inhibition, and behavioral activation were significant predictors of anxiety symptoms among university students. Among male students, exercise intensity (Beta= - 0.088, p = 0.001) and reward responsiveness (Beta= - 0.255, p < 0.001) showed the strongest correlations with anxiety levels, while among female students, exercise time (Beta = - 0.084, p < 0.001) and behavioral inhibition (Beta = 0.291, p < 0.001) were the most highly correlated. Physical activity levels had a direct effect of 84.37% on reducing anxiety symptoms (Beta= - 0.286, p < 0.001), with 15.63% of the effect mediated by the behavioral inhibition and activation system (Beta= - 0.053, p < 0.001). The mediating effects of the behavioral inhibition and activation system were stronger in females (29.92%, Beta= - 0.076, p = 0.001) compared to males (15.76%, Beta= - 0.061, p < 0.001). Factor loadings indicated that exercise time (male: 1.81, female: 2.71) and drive (male: 1.01, female: 1.04) were more effective in alleviating anxiety symptoms, particularly in the dimensions of uncontrollable worrying (1.07), worry too much (1.03), trouble relaxing (1.00), and nervousness (1.00). Physical activity exerts a direct influence on anxiety, with its anxiolytic effects partially mediated by the behavioral inhibition and activation system. This mediating effect is most pronounced in the female college student population.

Effects of life rules on mental health and behavioral problems among adolescent and youth students: A survey after the lifting of COVID-19 restrictions in China

OBJECTIVE

To explore the impact of life rules (including individual's life habits and life patterns, such as diet, sleep, and learning styles) on mental health and behavioral problems among adolescent and youth students after the lifting of COVID-19 restrictions in Sichuan, China and analyze the influencing factors of life rules.

METHODS

An online survey was conducted in middle schools, high schools, colleges and universities in Sichuan Province, China, from December 14, 2022, to February 28, 2023. Demographic information, COVID-19 epidemic-related questions, behavioral and mental health information were collected. Pearson chi-square tests and One-way ANOVA were used to compare the differences of drinking/smoking, suicidal ideation and attempts, internet addiction, anxiety, depression and PTSD among groups with different life rules. Multiple logistic regression analysis was used to analyze the influencing factors of life rules.

RESULTS

A total of 82,873 eligible participants (aged 12-24 years) were included in this study, 40,519 participants (48.9%) reported that their life rules were partially impacted by the COVID-19 pandemic, and 6,461 participants (7.8%) reported that their life rules were severely disrupted. A total of 61.2% of participants partially recovered their life rules, and 8.6% of participants did not recover their life rules. There were statistically significant differences among different groups in terms of drinking/smoking habits, frequency of drinking/smoking in the past year, volume of drinking/smoking, internet addiction, anxiety and depression symptoms, PTSD, suicidal ideation and attempts (all P < 0.01). There were significant differences in the degree of impact and recovery of life rules among different genders, residence, grade, family economic level, home study status, academic level, infection and isolation status (all P < 0.01).

CONCLUSIONS

Adolescent and youth students with disrupted life rules during and after the COVID-19 pandemic had significantly more mental health and behavioral problems. Targeted and specific psychosocial interventions should be urgently needed to reduce the mental health and behavioral problems among students.

Effects of the COVID-19 pandemic on the health of medical students transitioning from traditional education to distance learning: a prospective cohort

OBJECTIVE

To identify factors affecting the mental and physical health of first-year medical students during the period of rapid SARS-COV-2 spread in the COVID-19 pandemic to develop effective strategies for managing student well-being and education quality during global pandemics.

METHODS

656 first-year students of Sechenov University aged 17 to 23 years (17.91 ± 1.01 years) were included in an online anonymous survey. The study consisted of two assessment phases: in traditional training in September-December 2021 and in distance learning in January-March 2022. The State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory, the Cantril Self-Anchoring Scale, and an original questionnaire were used for evaluation.

RESULTS AND DISCUSSION

During the rapid COVID-19 spread in COVID-19 pandemic, most first-year medical students had a high level of reactive anxiety, accompanied by depressive disorders and vegetative-somatic manifestations that significantly reduced their adaptive potential, life quality and academic performance. All first-year students regardless of age were shown to be sensitive to stressful situation. The females demonstrated more pronounced psycho-vegetative changes compared to the males. Students of medical, pediatrics and medico-preventive faculties reacted more strongly to the current situation than students of dental and pharmaceutical faculties. The identified changes in the psycho-vegetative student status were associated, first of all, with the difficult sanitary-epidemiological SARS-COV-2 situation and related financial problems. Students considered the transition to distance learning to be the most important support measures. Temporary transition to distance learning led to the significant decrease in the anxiety level, correction of depressive and vegetative manifestations, and significant increase in the life quality that was of great importance for the education quality. Significant student support measures during COVID-19 pandemic were also financial, psychological and informational assistance. The obtained results made it possible to develop the effective strategies for managing student health and education quality during global pandemics.

Allostatic load in non-medical and medical college students

BACKGROUND

Physical ailments and mental illness among college students are surging in recent years, which warrants urgent and comprehensive health research.

OBJECTIVE

To investigate whether there is a disparity in allostatic load between medical and non-medical college students, and to identify the influencing factors on allostatic load.

METHODS

A cross-sectional study involving 8,253 college students was conducted. We used modified Poisson regression analysis of generalized linear models to examine allostatic load between the two groups of students based on biological, psychological, and sociological factors.

RESULTS

The prevalence risk of allostatic load in non-medical students was significantly higher than that in medical students (18.9% vs. 14.1%, P < 0.001). Modified Poisson regression revealed that risk factors like non-medical background (RR = 1.200, 95%CI 1.088-1.324), being female (RR = 1.121, 95%CI 1.004-1.251), history of hospitalization (RR = 1.170, 95%CI 1.053-1.300), alcohol drinking (RR = 1.321, 95%CI 1.034-1.687), total stress (RR = 1.042, 95%CI 1.014-1.070), abnormal illness behavior (RR = 1.106, 95%CI 1.079-1.134), anxiety (RR = 1.214, 95%CI 1.055-1.396), depression (RR = 1.230, 95%CI 1.051-1.440), somatization (RR = 1.319, 95%CI 1.147-1.517), and insomnia (RR = 1.811, 95%CI 1.610-2.036) were positively correlated with allostatic load, while protective factors like originating from the western region (RR = 0.682, 95%CI 0.546-0.851, P = 0.001), studying for more than 4 h per day, especially 6-8 h (RR = 0.748, 95%CI 0.657-0.852), exercising for 0.5 to 1 h (RR = 0.900, 95%CI 0.814-0.995), having a high level of global well-being (RR = 0.930, 95%CI 0.903-0.957), and multi-dimensional health perception (RR = 0.753, 95%CI 0.681-0.833) were negatively correlated with allostatic load.

CONCLUSION

This study proposes a multidimensional approach to understanding the health of college students. Non-medical and medical students show differences in health perception, behavior, lifestyle, emotional problems, and the social environment, leading to varied allostatic load risks and necessitating tailored health interventions.

CLINICAL TRIAL REGISTRATION

Not applicable.

Who still suffers? Effects of COVID-19 stressful experiences on somatic symptoms and anxious mood moderated by diurnal cortisol: A daily diary study

This daily diary study drew on the allostatic load model to examine the predictive effect of COVID-19 stressful experiences (CSE) on somatic symptoms and anxious mood, as well as applying the biological sensitivity to context model to explore whether diurnal cortisol moderated the above associations. A total of 101 Chinese college students retrospectively reported CSE in October 2020, followed by 5-day diary reports on somatic symptoms and anxious mood in November 2020, with salivary cortisol collected on Days 2 to 4 to measure cortisol awakening response (CAR), diurnal cortisol slope (DCS), and daily cortisol output (area under the curve with respect to ground, AUCg). Results of multilevel models showed that greater CSE predicted more somatic symptoms but not anxious mood, which was only observed at flatter CAR, flatter DCS, or low AUCg. Furthermore, three-way interactions of CSE, CAR, and AUCg significantly predicted both somatic symptoms and anxious mood. Specifically, greater CSE predicted more somatic symptoms at flatter CAR with low AUCg, while predicting higher anxious mood at flatter CAR with high AUCg. Our findings demonstrate the long-term consequences following the prior pandemic, especially highlighting the biological vulnerability related to the synergetic effects of diurnal cortisol rhythms and daily cortisol output.

Mental health and sociodemographic influences during COVID-19: Longitudinal findings from Iceland

The COVID-19 pandemic introduced numerous stressors and challenges that have had profound implications for mental health. This study examined the effects of the pandemic on mental health among Icelandic adults (n = 1766), using longitudinal survey data spanning three waves of data collection from 2019 to 2022. Symptoms of depression, anxiety, and stress increased from the beginning of the pandemic to the second time point, approximately one year into the pandemic, coinciding with reductions in happiness and social support. By the third time point, mental health remained slightly poorer than pre-pandemic levels, even after all COVID-19-related restrictions had been lifted. Unlike some other countries, COVID-19 infections in Iceland did not rise significantly until after the summer of 2021. Overall, participants perceived that the pandemic most adversely affected their social relationships and mental health. Prolonged periods in quarantine were predictive of these perceptions, albeit effect sizes were small. During the pandemic, women and younger participants reported slightly poorer mental health, while social support predicted better mental health outcomes. These results show that large societal stressors can significantly impact the mental health of populations. While social support is a prominent predictor of better mental health, additional variables may be needed to explain these effects fully.

Relationship between perceived social support and stoma self-efficacy in permanent colostomy patients: A correlational study

AIM

In the context of adjusting to life with a permanent colostomy, this study explored how perceived social support from family, friends and others influences patients' self-efficacy in managing their stoma and engaging with their social lives.

METHODS

The study employed a descriptive, correlational design to investigate the relationship between social support and self-efficacy in 94 colostomy patients between April 2021 and August 2022. Participants completed the Descriptive Characteristics Form, Multidimensional Scale of Perceived Social Support (MSPSS), and stoma self-efficacy scale (SSES). Descriptive statistics were used to summarise the data, and one-way ANOVA with Tukey HSD post-hoc test examined group differences. Pearson correlation assessed the relationship between age, social support and self-efficacy, while multiple linear regression identified factors independently associated with self-efficacy level.

RESULTS

The participants had a mean age of 56.9 ± 14.34 years, and 37.2% had been suffering from stoma complications for a duration ranging from 13 months to 5 years. The mean total score on the MSPSS was 64.3 ± 13.5, whereas the mean total score on the SSES stood at 71.22 ± 20.21. A moderate positive correlation (r = 0.419, p < 0.001) was observed between the total scores from the MSPSS and SSES. The increase in the total score on the MSPSS was a significant predictor (β = 0.293, p = 0.001) of the level of stoma self-efficacy, explaining 48.9% of the variance.

CONCLUSION

Stronger perceived social support was linked to higher stoma self-efficacy in permanent colostomy patients.

COVID-19 experiences and psychopathology symptoms in college students at the onset of the pandemic

Objective: The present study examined what specific aspects of the COVID-19 pandemic contributed to psychopathology symptoms among college students during the initial stages of the pandemic. Participants: One thousand and eighty-nine college students (Mage = 20.73, SDage = 2.93) enrolled at a university in New York participated in the study between March and May 2020. Methods: Participants completed self-report measures assessing pandemic-related experiences and psychopathology symptoms. Results: Results indicated that greater COVID-19-related life changes were uniquely associated with greater depression and post-traumatic stress symptoms. Greater concerns about school, home confinement, and basic needs were uniquely associated with greater depression symptoms. Finally, greater COVID-19 infection concerns were uniquely associated with greater generalized anxiety and post-traumatic stress symptoms. Conclusion: The present study indicates that the COVID-19 pandemic had a multifaceted impact on undergraduate students and that specific COVID-19 experiences contributed to higher rates of psychopathology symptoms.

Impact of distress and anxiety due to COVID-19 on digital addictions in university students in the third wave period

Abstract

Background

Digital addictions are a major problem worldwide, which has increased considerably during the COVID-19 pandemic. In this scenario, two important impact factors to explain this problem are stress and anxiety because of COVID-19. The objective of this research was to determine the impact of distress and anxiety due to COVID-19 on digital addictions.

Methods

cross-sectional, explanatory study. A total of 802 students from public and private universities residing in the city of Lima and Callao (Peru), with a mean age of 21.68 (SD = 3.11), selected by convenience sampling, participated in the study. The MULTICAGE CAD-4 questionnaire, the distress scale, and the anxiety scale by COVID-19 were applied.

Results

two models examined with structural equation modeling showed good fit indices (CFI and TLI > .95, RMSEA and SRMR < .06). The first model shows that the latent variables distress and anxiety due to COVID-19 have direct effects on digital addictions as a general construct (R 2 = 22%). The second model shows that the exogenous latent variables (stress and anxiety) have direct effects of different magnitudes on each digital technology, so the variance explained on smartphone addiction was higher (R 2 = 25%) with respect to internet (R 2 = 19%) and video game addiction (R 2 = 6%). It was also found that for every male, there are two females with high levels of distress and anxiety. Regarding the problematic use of smartphones and internet, there is a prevalence of 40% regardless of sex; but as for the problematic use of video games, there is a marked difference between males (18.8%) and females (2.7%).

Conclusion

the distress and anxiety caused by COVID-19 have a direct impact in aggravating digital addictions.

Unpacking the Mood States of Children and Youth in Saskatchewan, Canada, in the Context of the COVID-19 Pandemic: Insights from the "See Us, Hear Us 2.0" Study

BACKGROUND/OBJECTIVES

The COVID-19 pandemic created a growing need for insights into the mental health of children and youth and their use of coping mechanisms during this period. We assessed mood symptoms and related factors among children and youth in Saskatchewan. We examined if coping abilities mediated the relationship between risk factors and mood states.

METHODS

"See Us, Hear Us 2.0", a cross-sectional study of 563 child-parent dyads, provided the data. The dependent variable, current mood state, was measured by the CoRonavIruS health Impact Survey (CRISIS) scale. Independent variables included sociodemographics, behaviors, household conditions, and coping ability. Multiple linear regression and mediation analyses were conducted, ensuring sample representativeness with sampling weights and addressing missing data through multiple imputations.

RESULTS

The participants reported mood symptoms ("moderate" to "extreme") ranging from 23% to 38% on the CRISIS scale. Factors such as older children, hybrid learning, disrupted activities, and increased screen time worsened moods. The ethnic minority groups (BIPOC) living in mid-sized cities/towns experienced more negative moods compared to Whites residing in cities. Coping ability mediated the relationship between extracurricular activities and mood states.

CONCLUSIONS

Our results underscore the importance of tailored interventions, recognizing the diverse needs of specific age groups, gender identities, and ethnicities and addressing the adverse effects of the pandemic-related disruptions on the mental health and well-being of school children in Saskatchewan. Our study also suggests prioritizing the diverse needs of children and youth during the planning and implementation of mental health services in the province.

Knowledge, Awareness, and Influence of the COVID-19 Pandemic on Students of Biomedical Faculties: A Cross-Sectional Study

Background/Objectives: The COVID-19 pandemic has had a profound impact on physical, mental, and social aspects of life worldwide. This study aimed to explore and compare differences in knowledge, awareness, behavior, and the psychological impact of the pandemic among students of biomedical faculties at the University of Zagreb. Methods: A cross-sectional study was conducted between 27 November 2020 and 19 January 2021 involving 518 students from the School of Dental Medicine, School of Medicine, Faculty of Pharmacy and Biochemistry, and Faculty of Veterinary Medicine. An anonymous online questionnaire was distributed, assessing participants' knowledge about SARS-CoV-2, information sources, attitudes, and psychological responses. Data were analyzed using descriptive statistics and appropriate statistical tests. Results: The median knowledge score was 61.54%, with senior and female students demonstrating significantly more knowledge (p < 0.001 and p = 0.044, respectively). Students who consulted the scientific literature and official websites had higher knowledge levels (p < 0.001). Most participants used media and social networks for pandemic information, while scientific sources were underutilized. Psychological impacts were evident, with 46.3% expressing fear about the future and 25% reporting anxiety if they were to be infected. Additionally, those who engaged with the scientific literature were more likely to accept vaccination and showed lower levels of COVID-19 stigma. A majority (64.5%) believed that the media exaggerated the pandemic's risks. Conclusions: Biomedical students demonstrated moderate knowledge about COVID-19, with a clear link between scientific literacy and more informed, less stigmatizing attitudes. This study underscores the importance of reliable information sources in shaping public health awareness and highlights the need for further education on COVID-19 symptoms and preventive measures.

Young adult drinking during the COVID-19 pandemic: Examining the role of anxiety sensitivity, perceived stress, and drinking motives

Studies have shown that those high in anxiety were at increased risk for alcohol use during the COVID-19 pandemic. Tension reduction theory points to anxiety sensitivity (AS) as a potential risk factor. Drinking to cope may further increase this risk. During the pandemic, those high in AS may have experienced increased stress and drank to cope, which may have put them at risk for misusing alcohol. Objective: The current study tested the association between AS and alcohol outcomes, mediated by perceived stress and drinking motives, among young adults during the COVID-19 pandemic. Participants and Methods: Young adults (N = 143) self-reported on AS, perceived stress, drinking motives, and alcohol outcomes (i.e., use and problems). Results: A mediation analysis revealed that AS positively predicted alcohol problems, via coping motives, and positively predicted alcohol use, via perceived stress and enhancement/sociability motives. Conclusion: These results confirm AS-risk for young adult alcohol use during the pandemic and highlight perceived stress and drinking motives as mechanisms of risk.

Correlates of mental health of people living with HIV co-infected with SARS-CoV-2: findings from the COVIDHIV study in France

Background

The COVID-19 pandemic has severely affected vulnerable populations, especially individuals living with HIV/AIDS (PLWHA). The convergence of HIV/AIDS and COVID-19 presents unique challenges, exacerbating existing health concerns and magnifying the strain on individuals already grappling with compromised immune systems. This study aimed to investigate the mental well-being repercussions faced by PLWHA co-infected with SARS-CoV-2 in France.

Methods

COVIDHIV is a French multicenter cohort of PLWHA co-infected with SARS-CoV-2, which collected sociodemographic, clinical, and mental health data. Anxiety and depression symptoms and post-traumatic stress disorder (PTSD) were assessed by the Hospital Anxiety and Depression Scale (HADS) and the PTSD Checklist (PCL-S), respectively. Multivariable logistic regression was performed to identify factors associated with mental health outcomes at inclusion in the cohort.

Results

Of the 397 participants included, 64.7% were male. The mean age was 51.6 (± 11.8) years. The prevalence of mental health outcomes was 33.5% ([95%CI: 28.5-39.0%]) for anxiety, 21.0% ([16.8-25.9%]) for depression, and 12.2% ([8.9-16.5%]) for PTSD. In multivariable regression adjusted for sex, COVID-19 wave and duration between COVID-19 confirmation and enrolment, age (adjusted odds-ratio (aOR): 0.97 [0.95-0.99]), being professionally active (0.43 [0.25-0.75]), and the number of self-reported symptoms (1.17 [1.11-1.24]) were associated with anxiety. Being professionally active (0.34 [0.18-0.65]), living in a couple (0.52 [0.20-0.98]), number of self-reported symptoms (1.15 [1.08-1.22]), and hospitalization for COVID-19 (3.35 [1.34-8.33]) were associated with depression. The number of self-reported symptoms (1.27 [1.16-1.41]), psychiatric disorders (4.04 [1.48-11.11]), and perceived vulnerability to COVID-19 (4.53 [1.69-14.60]) were associated with PTSD.

Conclusion

The mental health is a challenging issue among the participants and needs to be closely monitored among people already affected by a chronic disease such as HIV. The findings underscore the urgent need for targeted support and interventions tailored to address the mental health needs of PLWHA facing the dual burden of HIV/AIDS and COVID-19.

Long-term Effects of COVID-19 on Sleep Patterns

OBJECTIVE

To examine the long-term impact of Coronavirus disease-2019 (COVID-19) on sleep patterns and the prevalence of sleep disorders and to increase public health awareness of long-term COVID-19.

MATERIAL AND METHODS

Using the Massachusetts General Brigham Research Patient Data Registry, Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) positive patients were surveyed about their sleep patterns before and after the viral infection. Information related to comorbid conditions and medications was obtained through chart review.

RESULTS

Two hundred and forty-six completed surveys were analyzed. Average age was 53.3±16.3 years, and they were predominantly non-hispanic white (84.1%) and female (74.3%). The mean body mass index (kg/m2) was 29.9±6.9, and a greater proportion were non-smokers (63.2%). After COVID-19, there was an increase in the percentage of participants reporting difficulty initiating (39±49% vs. 31±46% prior to COVID-19 infection P = 0.01). Similarly, the participants reported difficulty in maintaining sleep after COVID infection (57% vs. 43% prior to infection P < 0.001). Additionally, there was an increase in the use of sleep aids (30% vs. 24% before the infection P = 0.003). The participants also reported a decrease in feeling rested and an increase in the need for napping (58% vs. 36%, P < 0.0001) and (27% vs. 40%, P < 0.0001) respectively. The sleep symptoms persisted beyond 12 months in 28% of the participants.

CONCLUSION

SARS-CoV-2 infection had negative effects on sleep, and a significant proportion of adults experienced insomnia and daytime sleepiness beyond 12 months after recovering from the initial infection.

Measuring Psychological Response to Pandemics: Further Psychometric Investigation of the COVID Stress Scales

The COVID Stress Scales (CSS; Taylor et al., 2020b) were developed as a measure of stress related to any pandemic, making it a valuable self-report measure for potential future large-scale infectious disease outbreaks. Although the initial validation study of the CSS indicated evidence of its psychometric strength, further assessment is warranted of the measure's retest reliability, the long-term stability of its five-factor structure, discriminant validity, and its relationship with pandemic-related risk and precautionary behaviors. We examined these psychometric elements of the CSS using longitudinal data collected from a nationally representative sample of adults (N = 205) during the COVID-19 pandemic. Results indicate moderate retest reliability that is consistent with changing rates of morbidity. Results also support the five-factor structure and demonstrate convergent validity, discriminant validity, and the ability to predict relevant behavioral responses to an active pandemic. Use of the CSS for future pandemics is discussed.

Students supporting students: evaluating the impact of the COVID-19 pandemic on resident assistant mental health

OBJECTIVE

To examine the impact of the novel coronavirus SARS-CoV2 (COVID-19) pandemic on Residents Assistants (RA) at a public university in the Midwest.

PARTICIPANTS

Sixty-seven RAs that had been offered an RA position for the '20-'21 academic year.

METHODS

An online cross-sectional survey measuring socio-demographics, stress, and well-being was fielded. MANCOVA models evaluated the impact of COVID-19 on well-being of Current RAs and compared to the non-current RA groups.

RESULTS

Sixty-seven RAs provided valid data. Overall, 47% of RAs had moderate-severe anxiety and 86.3% had moderate-high level of stress. Current RAs perceiving a great impact of COVID on life had significantly more stress, anxiety, burnout, and secondary traumatic stress than those who did not. RAs who started then quit experienced significantly higher secondary trauma compared to Current RAs.

CONCLUSIONS

Further research is needed to better understand the experiences and of RAs and to develop policies and programs to support RAs.

Exploring the Levels of Stress, Anxiety, Depression, Resilience, Hope, and Spiritual Well-Being Among Greek Dentistry and Nursing Students in Response to Academic Responsibilities Two Years After the COVID-19 Pandemic

Background: Dentistry and nursing students experience significant anxiety, negatively impacting their well-being and academic performance. Objectives: This study aims to assess the prevalence and relationships of stress, anxiety, depression, resilience, hope, and spiritual well-being among dentistry and nursing students, identify demographic influences and propose strategies to enhance resilience and well-being. Methods: This study surveyed 271 students attending Greece's departments of dentistry and nursing at the National and Kapodistrian University of Athens, using an electronic questionnaire aimed to assess stress, anxiety, and depression (depression, anxiety, stress scale-DASS-21); resilience (resilience assessment questionnaire-RAQ8, brief resilience scale-BRS); hope (adult hope scale-AHS); and spiritual well-being (functional assessment of chronic illness therapy-spiritual well-being scale-FACIT-Sp-12). The survey also collected demographic data to identify factors influencing these variables. Statistical analyses, including hierarchical multiple linear regression and t-tests, were performed to analyze the relationships between variables. Results: The sample included 145 dentistry and 126 nursing students, with 68.6% female and 80.1% undergraduate. Half of the students reported mild or higher levels of stress (48.7%), anxiety (51.3%), and depression (53.5%). The prevalence of depression was the highest in our sample, followed by anxiety and stress. Higher family wealth was associated with reduced stress levels, while female undergraduate students reported higher levels of anxiety than their male counterparts. Hope was a strong predictor of resilience, but stress and worry had a negative correlation. Conclusions: Promoting students' well-being and academic success requires effective stress-reduction and resilience-building techniques to improve students' performance and support future healthcare professionals' personal sustainability and holistic growth.

Athletes' Perceived Team Climate, Social Support, and Optimistic Thoughts During the COVID-19 Pandemic

In the Spring of 2020, Coronavirus 2019 (COVID-19) was officially declared a global pandemic, which prompted an unprecedented number of changes to societal functioning. Amongst those who experienced significant life alterations were collegiate athletes within the United States (US). The purpose of this study was to examine the relationship between US athletes' perceptions of their team motivational climate, perceived support from coaches and teammates, and their optimistic thoughts during the COVID-19 pandemic. US collegiate athletes (N = 756; 56.3% female; Mage = 20.07 years, SDage = 1.57 years) across a variety of levels (e.g., Division I) and sports (e.g., basketball) were invited to participate in this study. Structural equation modeling analyses revealed significant positive associations between a caring and task-involving climate, athletes' feeling supported by their coaches and teammates, and athletes' optimistic thoughts during the COVID-19 pandemic. In addition, an ego-involving climate was significantly negatively associated with athletes' feeling supported by their coaches and teammates. The final results suggest that the supportive actions of coaches and teammates during difficult times can mediate the positive connection between perceptions of a caring-task-involving climate on athletic teams and an athlete's ability to stay optimistic during difficult life stressors.

Psychological Impact of Distance Learning on Children and Adolescents in Saudi Arabia: A Multi-City Analysis of Behavioral and Mental Health Outcomes During the COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic triggered a global transition to distance learning, which significantly impacted children's mental health. In Saudi Arabia, remote education began on 8 March 2020, lasting between 1.5 to 2.5 years. This study aims to explore the psychological effects of distance learning on children and adolescents, with a focus on mental health challenges and coping mechanisms.

METHODS

A cross-sectional study was conducted using an online survey distributed to parents of children aged 6 to 18 in the major metropolitan areas of Jeddah and Riyadh. The survey included demographic questions and the Arabic version of the Vanderbilt ADHD Diagnostic Rating Scale, a tool for assessing behavioral challenges, anxiety, and symptoms of attention deficit hyperactivity disorder (ADHD).

RESULTS

A total of 71.6% of families reported a positive experience with distance learning. A significant correlation was found between parents' marital status and children's ability to cope with remote education. Interestingly, children without ADHD symptoms experienced three times more negative outcomes than those with ADHD symptoms. However, despite reporting fewer negative experiences, children with ADHD exhibited increased symptom severity and academic difficulties. Of the students, 5.4% were diagnosed with predominantly inattentive ADHD, 1.8% with predominantly hyperactive/impulsive ADHD, and 3.9% with combined ADHD. Additionally, 7.2% of students screened positive for oppositional defiant disorder, 1.5% for conduct disorder, and 6.6% for anxiety or depression. Children from separated or divorced families were more likely to exhibit ADHD symptoms (p = 0.002). Children with ADHD symptoms reported a more positive experience with distance learning (p < 0.05).

CONCLUSION

This study represents the first comprehensive, multi-city investigation in Saudi Arabia examining the relationship between distance learning, sociodemographic factors, and mental health symptoms in children. The findings highlight the psychological challenges faced by children during the pandemic and emphasize the need for targeted interventions to support both mental health and academic outcomes. These results offer valuable insights for future research and inform strategies to address children's well-being in scenarios involving distance learning.

The associations between emotional empathy, emotional intelligence, and COVID-19-related stress among nursing students: a cross-sectional study

BACKGROUND

The COVID-19 pandemic has variably affected the stress levels among students. Nursing students, as the reserve force of medical resources and the successors of frontline nursing staff, warrant particular attention regarding their stress levels. This study investigates the relationship between emotional empathy, emotional intelligence, and COVID-19-related stress in nursing students and examines the masking role of emotional intelligence in this relationship.

METHODS

A cross-sectional study was conducted from March to June 2023 using multi-stage sampling method to recruit 1126 nursing students from a medical university. Participants completed a demographic information questionnaire, the COVID-19 Student Stress Questionnaire, the Multidimensional Emotional Empathy Scale, and the Trait Meta-Mood Scale. Data were analyzed using t-tests/ one-way ANOVA, Pearson correlations, multiple linear regression, and the PROCESS macro program to examine the relationships between emotional empathy, emotional intelligence, and COVID-19-related stress, as well as the masking role of emotional intelligence.

RESULTS

Statistically significant differences were observed in COVID-19-related stress scores among nursing students from different residential areas (P < 0.05); Emotional empathy was significantly positively correlated with emotional intelligence and its dimensions. Emotional empathy also showed a significant positive correlation with COVID-19-related stress. Emotional intelligence and its dimensions were significantly negatively correlated with COVID-19-related stress; Emotional empathy and emotional intelligence were significant predictors of COVID-19-related stress; Emotional intelligence and its dimensions demonstrated a masking effect on the relationship between emotional empathy and COVID-19-related stress, with total effect sizes of -0.023 for emotional intelligence, -0.021 for emotional attention, -0.017 for emotional clarity, and - 0.018 for emotional repair.

CONCLUSION

Emotional empathy and emotional intelligence were significant predictors of COVID-19-related stress among nursing students. Emotional intelligence masked the impact of emotional empathy on COVID-19-related stress. Schools should implement stress management programs for nursing students that focus on enhancing emotional intelligence and moderating excessive emotional empathy. These programs are particularly crucial during public health emergencies to reduce stress levels and promote mental well-being.

CLINICAL TRIAL NUMBER

Not applicable.

The prevalence of 12-month suicidal ideation and associated factors among university students in China: Findings from a three-wave cross-sectional study from 2021 to 2023

BACKGROUND

Many studies have shown that the COVID-19 pandemic has increased the risk of suicidal tendencies among the public. However, there is limited research reporting on the changing trends in suicidal ideation after 2020 in the context of the long-term normalization of COVID-19 prevention and control measures in China.

METHODS

The self-administered online questionnaire was adopted to collect 12-month suicidal ideation, depressive symptoms, anxiety symptoms, stress, and some demographic information from university students by convenient cluster sampling in Shandong, Shaanxi, and Jilin Provinces, China. Multivariate logistic regressions were performed to assess the association between different factors and suicidal ideation.

RESULTS

The prevalence of 12-month suicidal ideation from 2021 to 2023 among university students was 3.89 %, 5.81 %, and 4.33 %, respectively, showing a trend of first increasing and then decreasing. The trends presented a similar tendency in the subgroups according to gender, majors, and grades, except among urban freshman-year students. The associated factors of suicidal ideation were different among university students in different surveys. However, female gender, poor mental health, and depressive symptoms were linked to a higher risk of suicidal ideation.

LIMITATIONS

More representative large-scale longitudinal studies should be used to monitor the suicidal behavior of university students.

CONCLUSIONS

The prevalence of 12-month suicidal ideation among Chinese university students exhibited a pattern of initial increase followed by a subsequent decrease from 2021 to 2023. Despite the complete lifting of COVID-19 prevention and control measures in China, the prolonged three-year epidemic may have enduring adverse effects on university students, underscoring the ongoing importance of providing continuous mental health services to this population.

Chronic impacts of natural infrastructure on the physical and psychological health of university students during and after COVID-19: a case study of Chengdu, China

Introduction

The COVID-19 pandemic has underscored the health benefits of green spaces, yet research on how specific elements of natural infrastructure affect well-being during the pandemic has been limited.

Methods

This study, conducted at Sichuan Agricultural University with 300 students in 2022, investigated how urban natural infrastructure impacts physical and psychological well-being during the pandemic. Different aspects of natural infrastructure, such as thermal comfort, air quality (negative ion concentration), and noise and light levels, varied in their positive effects on students' health.

Results

The findings revealed that 65.6% of university students felt reduced stress when engaging with outdoor spaces, and 72.8% of them renewed recognized the therapeutic value of nature.

Discussion

The study emphasizes the importance of incorporating natural elements into urban planning to enhance outdoor activity and well-being, especially in post-pandemic settings. Recommendations are provided for future urban design to address the therapeutic needs of specific populations.

Prevalence of Internet Gaming Disorder, Depression, and Anxiety Symptoms Before and After the Pandemic

"Internet gaming disorder" (IGD) is a condition for further study in the DSM-5, with its prevalence estimated to be anywhere from 0.7% to 27.5% depending on the methodology used to measure it. Previous research has linked the symptoms of IGD to symptoms of depression and anxiety among college students. Methods: The current study explored the relationships between self-reported symptoms of IGD, depression, and anxiety in two small, non-overlapping samples of college students, one collected before the pandemic (n = 52) and another during the global pandemic (n = 89). Data on the time spent gaming, IGD, depression, and anxiety symptoms were collected via anonymous online surveys at a small Mid-Western liberal arts university. The samples differed significantly in age, likely due to the smaller incoming first-year class size as a result of many families deciding to defer the start of college in 2020. Conclusions: These findings partially support past research suggesting a small to moderate association between self-reports of IGD and depression symptoms. While the pandemic does not appear to have greatly changed the overall number of self-reported symptoms experienced or the time spent playing video games between the two samples, it may have exacerbated the relationship between these variables within the sample. The stronger relationship between symptoms of depression or anxiety and the time spent playing video games in the later sample may be particularly concerning if the trend continues, as it may lead to additional problematic gaming behavior in the future.

Interest in healthcare work post-pandemic: A study on social work students' perspectives

This study explored social work students' attitudes toward healthcare responsibilities after the Coronavirus Disease 2019 (COVID-19) pandemic. Surveying n = 184 third and fourth-year Social Work students revealed a generally negative attitude toward working in healthcare. Factors such as age, marital status, academic level, personal or familial virus infection history, COVID-19 vaccination status, presence of chronic illness, or experiencing a COVID-19-related death did not significantly influence these attitudes. The challenges faced in healthcare during the pandemic, including psychological and physiological impacts, underscore the importance of equipping Social Work students with the necessary knowledge and skills for future healthcare roles. This research suggests that addressing students' concerns and competencies in Social Work curricula may positively influence their future healthcare field engagement.

Anxiety and Depression Disorders in Undergraduate Medical Students During the COVID-19 Pandemic: An Integrative Literature Review

INTRODUCTION

The COVID-19 pandemic has triggered several challenges on the front of mental health. Undergraduate medical students face considerable stress in their academic routines. Thus, there is a need to explore the implications for the mental health of undergraduate medical students during the COVID-19 pandemic.

OBJECTIVE

To review the global literature about anxiety and depressive disorders in undergraduate medical students during the COVID-19 pandemic.

METHOD

We developed an integrative literature review on the occurrence of anxiety and depressive symptoms in undergraduate medical students during the COVID-19 pandemic. We included the manuscripts that used the PHQ-9 and/or GAD-7 questionnaires. We excluded systematic reviews, narrative reviews, integrative reviews, meta-analyses, and qualitative analytical studies. We assessed the results on the occurrence of anxiety and depression and the severity of symptoms in medical students during the COVID-19 pandemic using quantitative studies applying the GAD-7 questionnaire for anxiety or the PHQ-9 for depression.

RESULTS

We reviewed 85 selected studies, and the results showed a significant prevalence of moderate and severe symptoms of anxiety and depression, with 28.2% of participants presenting scores of ≥10 on the GAD-7 and 38.9% on the PHQ-9. Statistical analyses using simple and multiple regression tests revealed associations between higher rates of anxiety symptoms among students from developing countries and data collected after the lockdown period in 2020 during the pandemic lockdown. In addition, female students were at risk of depressive disorders. We emphasize as a limitation that the diagnosis of depression and anxiety requires a detailed clinical evaluation, which is not focused on in this actual study.

CONCLUSIONS

Our findings highlight the need for specific interventions to support the mental health of undergraduate medical students, especially female students from developing countries, during a pandemic crisis.

Blame others but hurt yourself: blaming or sympathetic attitudes toward victims of COVID-19 and how it alters one's health status

OBJECTIVE

This study explored the relationship between blame/sympathy and blamer's/sympathizer's perceived health status.

DESIGN

We recruited participants via an online survey platform. Study 1 was a cross-sectional study using data (N = 3304, Mage = 28.22, SDage = 7.92, and 39.3% female) collected from 30 provinces, municipalities, and autonomous regions of China on February 3, 2020. Study 2 used the daily diary method collecting data from February 4 to 9, 2020. Sample (N = 2456, Mage = 28.49, SDage = 7.49, and 39.4% were female) was obtained by inviting participants in Study 1 on the same platform.

MAIN OUTCOME MEASURES

Self-reported health status and life satisfaction.

RESULTS

In Study 1, blame was negatively associated with perceived health status, while sympathy was positively associated with it. Negative emotions and risk perception are the underlying mechanisms, but neither of them has effects on the relationship between sympathy and perceived health status. Study 2 replicated these results using multilevel analysis.

CONCLUSION

The results highlight the importance of people's attitudes on perceived health status. While sympathy is positively related to perceived health status, blaming has a negative association with perceived health status. Negative emotions and risk perceptions are the underlying mechanisms.

Assessing the Fear of Covid-19 in Psychiatric Patients: Results from an Italian Multicentric Study

Objective

Even though the COVID-19 emergency has concluded, its consequences are still relevant. Recent evidence suggests that a significant proportion of individuals experience persistent symptoms long after the initial infection has resolved, classified as "Long COVID" condition. Fear of COVID-19 increases anxiety and stress levels in healthy individuals and exacerbates the symptoms of those with pre-existing psychiatric disorders; therefore understanding the impact of the pandemic on psychiatric disorders remains of utmost importance. The present study aimed at assessing the prevalence and predictive factors of fear of COVID-19 in a sample of patients with different psychiatric conditions.

Method

A sample of 269 psychiatric patients were recruited from two different tertiary clinics in Italy and assessed with the Fear of COVID-19 Scale (FCV-19S). In order to compare patients with a significant fear of COVID-19 or without (Fear+ vs. Fear-) and to identify the main features in terms of clinical dimension, exploratory and predictive analysis were performed.

Results

Female gender, age at illness onset, and insight levels emerged as positive predictors of FCV-19S. Conversely, current substance abuse emerged as a negative predictor of fear levels. Moreover, significantly lower FCV-19S scores were observed in patients with a diagnosis of schizophrenia spectrum disorders.

Conclusions

Specific sociodemographic and clinical factors predicted higher levels of fear of COVID-19 in psychiatric patients. Further studies are warranted to determine the potential long-term consequences of the COVID-19 impact on mental health.

Investigating mental health outcomes of undergraduates and graduate students in Taiwan during the COVID-19 pandemic

Objective: This study is an exploration of the major stressors associated with the COVID-19 for students in higher education in Taiwan. Participants: The sample comprised 838 higher education students studying at various Taiwanese universities. Methods: A cross-sectional online survey was administered at different postsecondary institutions during the semi-lockdown period of COVID-19, which mandated online instruction. Machine learning was employed to determine the variables that most highly predicted students' mental health using R. Results: The findings revealed that COVID-19-related experiences, including social interactions, financial conditions, and educational experiences, were significantly associated with mental health outcomes. Particularly, loneliness are significantly related to social interactions and educational experiences. Conclusions: Findings revealed that Covid-19 impacted Taiwanese students' financial conditions, educational experiences, and social interactions, which were significant predictors of their mental health outcomes such as anxiety, loneliness and depression. The current study contributes to the gap in knowledge about mental health issues among postsecondary students during the pandemic.

Online Media Consumption, Fear, Mental Wellbeing, and Behavioral Compliance During the COVID-19 Pandemic: A Longitudinal Study

This study explored how online media consumption, fear, mental wellbeing, and behavioral compliance with COVID-19 measures were related to one another during the COVID-19 pandemic. Employing a four-wave longitudinal survey research design (n = 1,092), this study found positive relationships between online media consumption and fear of COVID-19, between fear of COVID-19 and behavioral compliance, and between behavioral compliance and mental wellbeing in the general Dutch population. Results showed a negative relationship between fear of COVID-19 and mental wellbeing. Repeated measures ANOVAs indicated that participants' online media consumption, fear of COVID-19, and behavioral compliance with COVID-19 measures all gradually decreased as the pandemic progressed, while mental wellbeing gradually recovered as the pandemic progressed. Recognizing the negative relationship between fear of COVID-19 and mental wellbeing, policymakers may be encouraged to focus on implementing interventions and communication strategies to support mental health during pandemics. Using other types of appeals (e.g. hope appeals) in addition to the commonly used fear appeals when developing online public health messages could ensure behavioral compliance during pandemics without triggering high levels of fear. This can contribute to maintaining people's mental wellbeing when they have to cope with life-threatening public health crises while still promoting behavioral compliance with necessary public health measures.

Stacked artificial neural network to predict the mental illness during the COVID-19 pandemic

The individual's mental health crisis and the COVID-19 pandemic lead to mental disorders. The transmission of the COVID-19 virus is associated with the levels of anxiety, stress, and depression in individuals, similar to other factors. Increases in mental illness cases and the prevalence of depression have peaked after the pandemic struck. The limited social intervention, reduced communication, peer support, and increased social isolation during the pandemic resulted in higher levels of depression, stress, and anxiety which leads to mental illness. Physiological distress is associated with the mental disorders, and its negative impact can be improved mainly by early detection and treatment. Early identification of mental illness is crucial for timely intervention to decelerate disorder severity and lessen individual health burdens. Laboratory tests for diagnosing mental illness depend on the self-reports of one's mental status, but it is labor intensive and time consuming. Traditional methods like linear or nonlinear regression cannot include many explanatory variables as they are prone to overfitting. The main challenge of the state-of-the-art models is the poor performance in detecting mental illnesses at early stages. Deep learning models can handle numerous variables. The current study focuses on demographic background, Kessler Psychological Distress, Happiness, and Health determinants of mental health during the pandemic to predict the mental health. This study's prediction can help rapid diagnosis and treatment and promote overall public mental health. Despite potential response bias, these proportions are exceptionally elevated, and it's plausible that certain individuals face an even higher level of risk. In the context of the COVID-19 pandemic, an investigation into mental health patients revealed a disproportionate representation of children and individuals with neurotic disorders among those articulating substantial or severe apprehensions.

Psychological health benefits of focusing on the 'here and now' versus a limited future during the COVID-19 pandemic

Objective: College students' psychological health has been negatively impacted by the COVID-19 pandemic (e.g., 1). We investigated whether students' psychological health was related to their orientation toward the future and mindfulness while considering previously-identified correlates of psychological health such as perceived risks of COVID-19. Participants: Participants were 278 college students at a mid-Atlantic US university in November and December 2020. Method: Using a self-report survey, we measured three aspects of psychological health (depression, anxiety, and stress) and future orientation, mindfulness, perceptions of risk, and the personal impact of COVID-19 on students' lives. Results: Multiple linear regression analyses showed that greater mindfulness and focusing less on a limited future were related to less depression, anxiety, and stress. Conclusions: Encouraging students to be mindful and focus on the present instead of focusing on a limited future may be beneficial for their psychological well-being during the COVID-19 pandemic.

Substance Use and Mental Health in Emerging Adult University Students Before, During, and After the COVID-19 Pandemic in Mexico: A Comparative Study

BACKGROUND

The COVID-19 pandemic significantly impacted mental health and substance use patterns, particularly among young adults.

OBJECTIVE

This study aimed to assess changes in anxiety, depression, self-esteem, and substance use among university students in Mexico before, during, and after the pandemic.

METHODS

Using a repeated cross-sectional design, this study was conducted with university students in Mexico across three periods: pre-pandemic (2017 and 2019); during the pandemic (2021); and post-pandemic (2023). A total of 2167 students were interviewed during one of the three periods. Standardized scales measured anxiety, depression, self-esteem, Erotic Response and Sexual Orientation Scale (EROS), and substance use.

RESULTS

showed a marked and significant increase in the proportion of students with anxiety (40.0%, 71.7%, and 79.6%) and depression (14.4%, 61.9%, and 62.6%) during the pre-pandemic, pandemic, and post-pandemic periods, respectively. Self-esteem significantly decreased during and after the pandemic, compared to pre-pandemic, particularly among females. The proportion of students categorized as moderate/high-risk for their substance use changed over time, showing a reduction in alcohol use (from 29.9% to 20.2%) and tobacco use (from 26.0% to 18.2%) but an increase in sedative use (from 7.1% to 11.7%), before vs after the pandemic, respectively. Multivariate analysis revealed that anxiety, low self-esteem, and increased sedative use were consistently linked to a heightened risk of depression during and after the pandemic. Notably, anxiety and depression levels remained in a proportion significantly elevated even in the post-pandemic period.

CONCLUSIONS

These findings underscore the enduring impact of the COVID-19 pandemic on the mental health of university students, highlighting the urgent need for targeted interventions, early detection strategies, and customized educational programs to effectively support students' mental well-being in the ongoing post-pandemic era.

Impact of pandemic-related worries on mental health in India from 2020 to 2022

This study examines how pandemic-related worries affected mental health in India's adults from 2020 to 2022. Using data from the Global COVID-19 Trends and Impact Survey (N = 2,576,174), it explores the associations between worry variables (financial stress, food insecurity, and COVID-19-related health worries) and self-reported symptoms of depression and anxiety. Our analysis, based on complete cases (N = 747,996), used survey-weighted models, adjusting for demographics and calendar time. The study finds significant associations between these worries and mental health outcomes, with financial stress being the most significant factor affecting both depression (adjusted odds ratio, aOR: 2.36; 95% confidence interval, CI: [2.27, 2.46]) and anxiety (aOR: 1.91; 95% CI: [1.81, 2.01])). Models with interaction terms revealed gender, residential status, and calendar time as effect modifiers. This study demonstrates that social media platforms like Facebook can effectively gather large-scale survey data to track mental health trends during public health crises.

Evolving Trends in College Students' Health Education: A Bibliometric Analysis

This study offers new insights into college students' health education (CSHE) regarding its research status, hot spots, and trends by conducting a comprehensive bibliometric analysis of this field in the past decade (2014 to 2024). Specifically, we analyzed publication trends and used the bibliometric method with CiteSpace software to explore collaborative networks, detailed co-citation status, and co-occurrence dynamics based on 1358 Web of Science Core Collection articles. Our results indicate increased relevant publications and the collaboration networks show complex institutional and regional partnerships. At the same time, co-citation and co-occurrence analyses highlight interdisciplinary research themes that encompass public health. The study particularly underscores the emerging importance of mental health, global health, and innovative educational approaches. These findings reveal trends in CSHE research and provide crucial insights for future studies, stressing the need for interdisciplinary collaboration and creative strategies to tackle student health challenges. Moreover, in practice, this study contributes to promoting and practicing targeted health intervention policies and countermeasures aimed at enhancing student well-being, such as establishing dedicated health education courses, providing specialized training for teachers, conducting regular health assessments, and providing funding for CSHE.

Addressing psychological resilience and its determinants among university students during the COVID-19 pandemic: a three-wave longitudinal study in Shandong Province, China

BACKGROUND

The relationship between public health emergencies and psychological distress had been well known, yet none research had been conducted on the trend in psychological resilience and its longitudinal determinants during the pandemic. This study aimed to explore the changes of psychological resilience of university students during COVID-19 pandemic, and further clarify the longitudinal relationship between family factors, mental health, social mentality and psychological resilience.

METHODS

Questionnaires were distributed to students from five universities in Shandong Province, China during the COVID-19. A total of 1635 students were finally included in this three-wave follow-up study using stratified random sampling method. Mental health was assessed by Depression Anxiety Stress Scale, social mentality was measured by the Bi-Dimensional Structure Questionnaire of Social Mentality, psychological resilience was evaluated by the Chinese version of the Psychological Resilience Scale. Repeated-measures analysis of variance was used to analyze the longitudinal changes of psychological resilience, generalized estimating equation (GEE) was conducted to estimate the determinants of psychological resilience.

RESULTS

Psychological resilience changed from 28.37 in Wave 1, 29.10 in Wave 2, and 29.15 in Wave 3 among the university students. The students who majored in Art (β = 0.872, P = 0.032), parents (mother β = 0.546, P = 0.035; father β = 0.718, P = 0.012) had a greater influence on children's personality, and positive social mentality (β = 5.725, P < 0.001) were more likely to report a higher psychological resilience. Being female (β=-0.932, P < 0.001), not being a student leader (β=-0.911, P < 0.001), being anxious (β=-1.845, P < 0.001) and depressed (β=-1.846, P < 0.001), and negative social mentality (β=-0.803, P < 0.001) were less likely to report a higher psychological resilience.

CONCLUSIONS

The psychological resilience of the university students in Shandong Province, China increased significantly from Wave 1 to Wave 3 during the COVID-19 pandemic. Majoring in Art, parents having a greater influence on children's personality, better mental health, positive social mentality were more likely to report a higher psychological resilience, while female, not student leader, worse mental health, and negative social mentality were less likely to report a higher the psychological resilience.

Prevalence and Correlates of Likely Anxiety Disorder in Ghana During the COVID-19 Pandemic: Evidence From a Cross-Sectional Online Survey

BACKGROUND

The COVID-19 pandemic created stressors to daily living, leading to increased mental health problems. It is important to assess the influence of COVID-19 pandemic on mental health, specifically anxiety.

OBJECTIVES

The goal was to determine the prevalence and sociodemographic, clinical, and other correlates of likely Generalized Anxiety Disorder (GAD) among study subjects in Ghana.

DESIGN

This study employed a cross-sectional approach, using an online survey administered primarily through social media platforms. The survey questions included the GAD-7 scale, which was used to assess likely GAD in respondents. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression analysis.

PARTICIPANTS

Overall, 756 respondents completed the survey, mainly from Ashanti and Greater Accra, which were the hardest hit by COVID-19.

RESULTS

The prevalence of likely GAD in our sample was 7.6%. Gender, loss of job due to COVID-19, and seeking mental health counseling were independently associated with increased likelihood of GAD.

CONCLUSIONS

The findings suggest that women, those who lost their jobs due to the COVID-19 pandemic, and those who sought mental health counseling were more likely to experience moderate to high anxiety symptoms as a result of the COVID-19 pandemic. Priority must be attached to psychological support measures for members of these groups.

Depression, anxiety, and help-seeking among Slovenian postsecondary students during the COVID-19 pandemic

Introduction

The COVID-19 pandemic has faced students with many challenges, contributing to their mental distress. This article explores the role of demographic characteristics, psychological status, year of study, and social support during the COVID-19 pandemic in explaining Slovenian university students' mental health problems and help-seeking behavior.

Methods

In February and March 2021, data were collected on 5,234 full-time Slovenian postsecondary students who were enrolled in public and concessionary independent higher education institutions. Participants completed a questionnaire, which included The Patient Health Questionnaire (PHQ-9), General Anxiety Disorder questionnaire (GAD-7), Oslo Social Support Scale (OSSS-3), and items measuring psychological status, help-seeking behavior and demographics. Data were analyzed using multiple linear regression and hypothesis testing for differences.

Results

Factors, such as gender, age, psychological status and social support, contributed to experiencing anxiety and depression among Slovenian students during the COVID-19 pandemic, with year of study additionally contributing to experiencing depression. Similarly, gender, age, psychological status and social support contributed to help-seeking behavior. Higher levels of depression and anxiety were reported by female students, students with prior mental disorders, and students with lower social support levels. Female students and students with lower social support levels reported more frequent help-seeking behaviors.

Conclusion

The results provide insight into the mental state of the Slovenian student population in the context of imposed public health measures at the end of the second COVID-19 wave in Slovenia. The findings can help identify vulnerable groups within the student population to whom we must be particularly attentive in times of crisis.

Social isolation, psychological distress and resilience of Chinese college students during COVID-19 pandemic

It has been 3 years since the first appearance of COVID-19 in China. During this time, social isolation was widely used as an important method to fight it. However, this measure had many negative effects on the mental health of college students. To better understand this issue, this study aims to explore the impact of social isolation and COVID-19-related stress on psychological distress among Chinese college students. Additionally, resilience has been evaluated as a key component of stress resistance in this situation. Coronavirus Stress Measure (CSM), the Connor-Davidson Resilience Scale (CD-RISC) and the Brief Symptom Inventory (BSI) were used in this study. A total of 388 Chinese college students participated in the survey via the Internet. Two groups (isolated group vs. non-isolated group) were divided according to whether they have been isolated from their classmates and families. Data analysis adopts t-test, F test and mediate effect analysis by SPSS21.0. (1) All factors, except resilience, were found to have lower scores in the isolated group; (2) significant correlations were found between all factors; (3) resilience partially mitigated the impact of COVID-19 stress on psychological symptoms. Social isolation has been found to be a significant factor contributing to negative psychological distress in Chinese college students. The COVID-19-related stress may increase the likelihood of psychological suffering among isolated group. Resilience can help reduce the negative effects of COVID-19 stress on college students. Therefore, providing appropriate psychological support tailored to different isolation situations is crucial.

Understanding psychological symptoms among Chinese college students during the COVID-19 Omicron pandemic: Findings from a national cross-sectional survey in 2023

During the Omicron pandemic in late 2022, this study surveyed Chinese students via an online questionnaire to assess their mental health status, prevalence of psychological symptoms, and associated factors. A nationwide cross-sectional survey of 4254 participants was conducted in seven regions of China from January 5 to February 9, 2023. Scales were utilized respectively to measure depressive symptoms, anxiety symptoms, post-traumatic stress disorder (PTSD) symptoms, and perceived social support. Descriptive, univariate, and multivariable analyses were performed to identify associated factors. Protective factors against depressive symptoms include regular exercise and robust social support networks, while risk factors involve excessive alcohol consumption, comorbidities, Omicron infection, and irregular sleep patterns. Risk factors for anxiety symptoms include comorbidities, Omicron infection, living alone, and irregular sleep patterns, while social support emerges as a protective factor. For PTSD symptoms, regular exercise and strong social support systems are identified as protective measures, with risks associated with comorbidities, Omicron infection, and poor sleep quality. Students are particularly vulnerable during the pandemic due to their lifestyle and academic pressures. It's essential to bolster their social support and promote healthier habits.

Concerns of osteopathic medical students during the COVID-19 pandemic

OBJECTIVES

This study aims to quantify the areas of most concern in medical students in relation to their residency application in the setting of the COVID-19 pandemic and to identify risk factors for all that cause concern and specific areas of concern in a population with well-established high rates of anxiety at baseline. The COVID-19 pandemic introduced sweeping changes to medical education that had wide-ranging effects on medical students and their applications for medical residencies.

METHODS

In August 2020, we utilized a cross-sectional study to quantify student's areas of concern related to residency application related to the COVID-19 pandemic. We asked participants to rate their levels of concern in 15 different aspects related to medical residency applications and the perceived impact that COVID-19 had on each.

RESULTS

The survey was distributed to 984 osteopathic medical students, with 255 complete responses. The three areas of greatest impact were shadowing opportunities (4.15), volunteer opportunities (4.09), and conferencing opportunities (4.09). The most salient demographic variables were year in school, sex, and locale. Females reported higher levels of concern across all categories in the study compared to males, with statistical significance across all categories (all p<0.05, Range d=0.16 to 0.43), except for letters of recommendation and sub-internships.

CONCLUSIONS

The areas of most concern identified in our study were consistent with prior studies and may implicate the pressures that female medical students may feel compared to their male counterparts. The underlying cause(s) may be subject to future research.

Prevalence of anhedonia, anxiety, and their impact on food consumption among postgraduate Qassim University students

Objectives

A prevalent symptom of many mental health issues, such as depression, is anhedonia, which is the inability to feel joy or pleasure. Tension-induced sensations, anxious thoughts, and bodily alterations are the hallmarks of anxiety. One known environmental factor that affects mental health is diet. In this implication, eating appetizing meals has been proposed to reduce unpleasant feelings like worry. This study aimed to indicate whether eating habits among postgraduate students are related to symptoms of anhedonia and/or anxiety.

Methods

In a cross-sectional study, responses were collected from a total of 393 postgraduate students. Each student self-answered the General Anxiety Disorder-7, Snaith-Hamilton Pleasure Scale for Anhedonia, and the Food Consumption Questionnaire and reported the body weight.

Results

The prevalence of anhedonia was 28%, moderate anxiety and severe anxiety were 15.7 and 10.9%, respectively. In this research, results showed that sugary foods, fast food, and fried foods were positively associated with anxiety and anhedonia. However, fruits and vegetables were negatively associated with anxiety and anhedonia. Linear regression showed that fruit and drinking water consumption was significant with the number of meals/day. There was no significance between the number of meals per day and anhedonia; however, there was statistical significance with the total GAD-7 scale score regarding the number of meals/per day.

Conclusion

Anhedonia and anxiety are associated with food consumption, especially foods rich in sugars, fast and fried, which help to increase positive feelings. Future studies should focus on understanding the relationship between food consumption and following a healthy diet and improving and reducing symptoms of anxiety and anhedonia in those who suffer from a stressful or task-filled lifestyle, such as students, especially postgraduate students. In addition, it focuses on the importance of awareness of the symptoms of anhedonia, which is classified as a depressive disease, and how to control anxiety to maintain better mental health.

Mask wearing and self-harming thoughts among international students in the United States during COVID-19: The moderating role of discrimination

Objective: This study examined associations among discrimination, mask-wearing behavior, and self-harming thoughts among international students in the United States during COVID-19. Participants: Undergraduate and graduate international students enrolled in universities during the 2020 summer semester participated in the online survey (N = 103). Methods: Perceived discrimination, mask-wearing behavior, and self-harming thoughts during COVID-19 were assessed by self-reports. Multivariable logistic regressions examined the association among discrimination, mask-wearing behavior, and self-harming thoughts and explored the potential moderation effect of discrimination on the association between mask-wearing and self-harming thoughts. Results: 18.6% of participants reported self-harming thoughts. Increased discrimination was significantly associated with increased odds of self-harming thoughts. Discrimination significantly moderated the association between mask wearing and self-harming thoughts. Conclusions: The findings highlight the importance of increased availability of culturally appropriate mental health services for international students and the need for increased advocacy to decrease discrimination against international students in the current societal context.

Sleep Disturbances in Health Professional Students During the COVID-19 Pandemic: A Concept Analysis

AIM

The aim is to delineate the concept of sleep disturbances in health professional students during the COVID-19 pandemic.

DESIGN

A concept analysis was conducted.

METHODS

A systematic search was conducted for relevant articles published and performed from inception to July 5, 2024. Electronic databases searched included PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Web of Science. Rodgers' method of evolutionary concept analysis was used.

RESULTS

A total of 50 pertinent articles were included in our analysis. Utilising inductive thematic analysis, this study identified attributes, antecedents and consequences of sleep disturbances. Important attributes included insomnia, disrupted sleep patterns, altered sleep duration/nocturnal sleep duration and poor sleep quality. Antecedents encompassed factors such as gender, age/grade levels, physical activity, screen time of digital production, mental health issues, COVID-19-related stressors, financial strain and academic stress. Consequences included both mental and physical health implications. By addressing sleep disturbances and promoting better sleep health among students, we can enhance their learning and performance, which could translate to improved patient care outcomes. Additionally, understanding and mitigating sleep disturbances can contribute to the development of a more resilient and effective health care workforce, capable of providing high-quality care even during crises like the COVID-19 pandemic.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Parent and Young Adult Perspectives About the Transition to College During the COVID-19 Pandemic

PURPOSE

The purpose of this study was to describe the influence of COVID-19 on parents and their young adults with type 1 diabetes as they navigated the college environment during the COVID-19 pandemic.

PARTICIPANTS

A sample of 9 college students with type 1 diabetes and their parents were recruited to participate in interviews via purposive sampling methodology.

METHODS

A descriptive, qualitative study was conducted using semi-structured questions via recorded video conferencing interviews.

RESULTS

Three themes related to navigating type 1 diabetes at college during the pandemic emerged: (1) isolation and mental health: COVID-19-related isolation and loneliness; (2) risk and exposure to COVID-19: balancing risk of COVID-19 with type 1 diabetes; and (3) management of type 1 diabetes on campus during the pandemic: academics, university policies, and their impact on type 1 diabetes.

CONCLUSIONS

Students with type 1 diabetes and their parents had to navigate a complex set of concerns that extended beyond the usual challenges of diabetes management during the COVID-19 pandemic. Providers must provide additional support and incorporate education about type 1 diabetes management strategies to families affected by large-scale health crises.

Evaluation and Future Challenges in a Self-Guided Web-Based Intervention With and Without Chat Support for Depression and Anxiety Symptoms During the COVID-19 Pandemic: Randomized Controlled Trial

BACKGROUND

The COVID-19 pandemic has had an impact on mental health worldwide. Low- and middle-income countries were largely affected by it. Mexico was one of the most affected countries. Extended periods of lockdowns, isolation, and social distancing, among other factors, highlighted the need to introduce web-based psychological interventions to the Mexican population. In this context, Mental Health COVID-19 emerged as a self-guided web-based intervention (SGWI) aimed at adults to improve mental health during the COVID-19 pandemic.

OBJECTIVE

This study aims to assess the efficacy of 2 modalities of a self-guided intervention (with and without chat support) in reducing depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation. In addition, it aimed to compare the moderating role of coping strategies, acceptance, and satisfaction in participants' symptom reduction. We hypothesize that the self-guided, chat-supported modality will show higher efficacy than the modality without chat support in achieving clinical change and better performance as a moderator of depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation, as well as an increase in participants' satisfaction and acceptability.

METHODS

A randomized controlled trial was conducted. Data were collected from May 2020 to June 2022. We performed intrasubject measures at 4 evaluation periods: pretest, posttest, and follow-up measurements at 3 and 6 months. Differences between intervention groups were assessed through the Mann-Whitney U test for continuous variables and the chi-square test for categorical variables. Changes due to intervention were analyzed using Wilcoxon W test. Moderated regression analysis was performed to test the hypothesized moderating role of coping strategies, usability, and opinion about treatment on clinical change.

RESULTS

A total of 36 participants completed the intervention; of these, 5 (14%) were part of the SGWI group, and 31 (86%) were on the SGWI plus chat support (SGWI+C) group, which included a chat service with therapists. The perceived high complexity of the system for the SGWI group had a moderating effect associated with a lack of efficacy of the intervention regarding depression, but not when controlled for sociodemographic variables. A perception of lower helpfulness of the intervention was associated with poorer outcomes. Coping strategies did not show moderating effects.

CONCLUSIONS

Enhancing the utility of web-based interventions for reducing clinical symptoms by incorporating a support chat to boost treatment adherence seemed to improve the perception of the intervention's usefulness. Web-based interventions face several challenges, such as eliminating complexities in platform use and increasing the users' perceived utility of the intervention, among other issues identified in the study.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/study/NCT04468893?tab=results.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/23117.

COVID-19 lockdown and lifestyles: A narrative review

Background

The primary objective worldwide during the coronavirus disease 2019 (COVID-19) pandemic had been controlling disease transmission. However, lockdown measures used to mitigate transmission affected human behavior and altered lifestyles, with a likely impact on chronic non-communicable diseases. More than a year into the pandemic, substantial peer-reviewed literature emerged on altered lifestyles following the varying lockdown measures imposed globally to control the virus spread. We explored the impact of lockdown measures on six lifestyle factors, namely diet, physical activity, sleep, stress, social connectedness, and the use of tobacco, alcohol, or other harmful substances.

Methods

We comprehensively searched PubMed and the World Health Organization's global literature database on COVID-19 and retrieved 649 relevant articles for the narrative review. A critical interpretative synthesis of the articles was performed.

Results

Most of the articles included in the review identified the negative effect of lockdown measures on each of the lifestyle factors in many parts of the world. Encouraging lifestyle trends were also highlighted in a few articles. Such trends can positively influence the outcome of lifestyle-related chronic diseases, such as obesity and diabetes.

Conclusions

The lockdown associated with COVID-19 has largely had a negative impact on the lifestyles of individuals and communities across many countries and cultures. However, some individuals and communities also initiated positive lifestyle-related behavioral changes. If the knowledge generated by studying the impact of COVID-19-related lockdowns on the six lifestyle factors is further consolidated, it could improve chronic disease outcomes. This will help better understand lifestyle behaviors amidst crises and assist in redesigning extreme public health measures such as lockdowns.. It is up to governments, communities, and healthcare/academic entities to derive benefit from lessons learned from the pandemic, with the ultimate objective of better educating and promoting healthy lifestyles among communities.

Predictors of Poor Mental Health Outcomes in Healthcare Workers during COVID-19: A Two Waves Study

Objective: This cross-sectional study aimed to identify potential predictors of poor mental health outcomes among healthcare workers in two different waves of the COVID-19 emergency in Italy. Methods: An online survey collected data from N = 557 healthcare workers (21-77 years). The study predictors were sociodemographic characteristics, occupational status, factors related to the work environment, COVID-19-related adverse events, and lifetime traumatic events. The poor mental health outcomes that were considered were depersonalization/derealization, anxiety, depression, and somatization symptoms. Results: The main predictors of poor mental health outcomes were sleeping less than six hours per night, inadequate protective equipment measures, female gender, personal and familiar infection, living alone, working as a nurse, and working in a COVID-19 ward. Healthcare workers in 2021 reported experiencing more serious accidents and stressful events than those of the first wave. Depressive symptoms and COVID-19-related adverse events were higher in the second pandemic outbreak than in the first. Conclusions: Preventive strategies against poor mental health outcomes should be particularly focused on female nurses who live alone, work in areas with high infection rates, and have experienced the COVID-19 infection personally or who are close to people that have experienced the infection.

Depressive and anxiety symptoms among university students during the later stages of the COVID-19 pandemic in Germany - Results from the COVID 19 German Student Well-being Study (C19 GSWS)

Introduction

Data on the mental health of university students in Germany during the later stages of the pandemic is still limited. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 1.5 years after the first COVID-19 restrictions and (2) which factors were associated with these outcomes.

Methods

The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 6,996 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analyzed using multivariable logistic regression models.

Results

The mean age of the participants was 23.9 years (SD = 4.8), 67% were female and 31% male. The prevalence for depressive symptoms was 29 and 32% for anxiety. The lack of a trusted person and financial difficulties were associated with anxiety and depressive symptoms. Being worried that someone in one's personal network had become severely ill with COVID-19 and concern about (re)infection with COVID-19 were associated with anxiety symptoms. Those with pre-existing health conditions had an up to 1.98-times higher chance for reporting depressive symptoms (OR, 95% CI: 1.01-3.88) and an up to 2.27-times higher chance for anxiety symptoms, respectively (OR, 95% CI: 1.15-4.46).

Conclusion

Concepts for prevention and counseling to tackle mental health problems in students are needed and programs should take specific stressors in times of crises into account.