Prevalence and Psychosocial Correlates of Mental Health Outcomes Among Chinese College Students During the Coronavirus Disease (COVID-19) Pandemic

The relations between COVID-19 stress, social connectedness, and mental health: a longitudinal investigation comparing Chinese and American college students

College students in the U.S. and China have faced significant challenges during COVID-19. Data were collected from 120 Amerian students (Mage = 19.48, SDage = 1.30) and 119 Chinese students (Mage = 18.61, SDage = 0.91) in November, 2019 and March, 2020 to examine risk and protective factors for mental health (depression, anxiety, life satisfaction) during the pandemic, and potential cultural and gender differences. Results indicated that the frequency and impact of COVID-19-related stressful life events predicted deterioration of mental health over time, while social connectedness before the pandemic buffered the negative impact of COVID-19 stressful life events on life satisfaction. Chinese students reported higher levels of social connectedness and larger impact of COVID-19-related stressful life events, but lower frequency of stressful life events than American students. Stressful life events and social connectedness predicted mental health outcomes similarly for Chinese and American students. Gender differences were identified. Females reported more stressful life events, higher levels of depression, anxiety and less life satisfaction during COVID-19 than males. In addition, the frequency of stressful life events had a stronger impact on depression and anxiety for females compared with males. It is important to implement prevention and intervention programs to promote social connections and wellbeing among college students, especially among female students.

Associations between Mental Health and COVID-19 Status among 18- and 19-Year-Old Adolescents: A Multi-Country Study

The aim of this study was to describe the mental health status of 18- and 19-year-old adolescents who were infected or affected by COVID-19 during the first wave of the COVID-19 pandemic. This was a secondary analysis of a dataset collected from 152 countries between July and December 2020. Dependent variables were anxiety, depression, and post-traumatic stress symptoms. The independent variable was COVID-19 status (tested positive for COVID-19, had COVID-19 symptoms but did not test, had a close friend who tested positive for COVID-19, knew someone who died from COVID-19). Three multivariable logistic regression analyses were conducted to determine the associations between the dependent and independent variables while adjusting for confounding variables (sex—male, female, and country income level). Data of 547 participants were extracted, and 98 (17.9%) had experienced depression, 130 (23.8%) had experienced anxiety, and 219 (40.0%) had experienced post-traumatic stress symptoms. Knowing someone who died from COVID-19 was associated with significantly lower odds of having post-traumatic stress symptoms (AOR: 0.608). Having COVID-19 symptoms but not getting tested was associated with significantly higher odds of having anxiety symptoms (AOR: 2.473). Results indicate diverse mental health responses among adolescents aged 18–19-years old as a sequela of COVID-19. This needs to be studied further.

Trajectory of suicidal ideation among medical students during the COVID-19 pandemic: the role of childhood trauma

BACKGROUND

The aim of this study was to understand the longitudinal trajectory of suicidal ideation (SI) among Chinese medical students and the role of childhood trauma (CT).

METHODS

Using a whole-group sampling method, we assessed SI in 2192 (male = 834, female = 1358) medical students on three occasions over a period of one year. The Suicidal Ideation Self-Assessment Scale (SISAS) and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess SI and CT. The growth mixture modeling (GMM) was used to classify the developmental trajectory of SI.

RESULTS

A greater number of medical students were experiencing suicidal ideation during the COVID-19 pandemic. The trajectory of SI among medical students was divided into two groups: a low risk, slowly rising group and a high risk, continuous group. The low risk, slowly rising group had a significant time effect (B = 1.57, p < 0.001) and showed a slowly increasing trend. Emotional neglect (EN), physical neglect (PN), emotional abuse (EA) and physical abuse (PA) all had significant positive predictive effects for the high risk, continuous group (B = 0.18-0.65, P < 0.01).

CONCLUSION

The trajectory of SI among medical students can be divided into a low risk, slowly rising group and a high risk, continuous group; the more EN, PN, EA and PA experienced during childhood, the more likely medical students are to develop a high risk, continuous state of SI.

Changes in mental health and help-seeking among young Australian adults during the COVID-19 pandemic: a prospective cohort study

BACKGROUND

Young people may have elevated risk for poorer mental health during the coronavirus disease 2019 (COVID-19) pandemic, yet longitudinal studies documenting this impact are lacking. This study assessed changes in mental health and help-seeking since COVID-19 restrictions in young Australians, including gender differences.

METHODS

Data were drawn from a recent subsample (n = 443; 60% female; Mage = 22.0) of a prospective cohort originally recruited in secondary school to complete annual surveys. The subsample completed an additional COVID-19 survey during COVID-19 restrictions (May-June 2020), which was compared to responses from their latest annual survey (August 2019-March 2020). Mixed effect models with time and gender as the primary predictors were conducted for: (i) scores on the Patient Health Questionnaire Depression 9-item (PHQ-9) and Generalised Anxiety Disorder 7-item (GAD-7) modules assessed before and during COVID-19 restrictions, and (ii) self-reported help-seeking from a health professional in February 2020, and the month preceding May-June 2020.

RESULTS

Mean symptom scores increased from before to during COVID-19 restrictions on the PHQ-9 (coefficient: 1.29; 95% CI 0.72-1.86) and GAD-7 (0.78; 95% CI 0.26-1.31), but there was no increase in help-seeking over time (odds ratio 0.50; 95% CI 0.19-1.32). There was no evidence of differential changes by gender.

CONCLUSIONS

This study found increases in depression and anxiety symptoms but not greater help-seeking among young Australian adults during the first wave of the pandemic. Increasing availability and awareness of accessible treatment options and psychoeducation is critical, as well as further research into risk and protective factors to help target treatment to this vulnerable age group.

The effect of Bafa Wubu of Tai Chi on college students' anxiety and depression: A randomized, controlled pilot study

Objective: This pilot study aimed to explore the mechanism of the effects of Bafa Wubu of Tai Chi (BWTC) on anxiety and depression in college students using resting-state functional magnetic resonance imaging (RS-fMRI). Methods: Eighteen college students (5 males and 13 females) with anxiety and depression met the study criteria and were randomly divided into an experimental group (aged 24.20 ± 4.07 years) and a control group (aged 22.50 ± 5.95). The experimental group received an eight-week BWTC intervention five times/week for 60 min/session. The control group maintained normal daily life without any exercise intervention. These students were assessed using RS-fMRI scans, the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS). Spearman correlation analysis was used, and statistical significance was defined as a two-sided p-value of <0.05. Results: After the intervention, the SAS and SDS scores of the BWTC group significantly reduced (p = 0.002; p = 0.001). Compared with the control group, the fALFF values of the right middle frontal gyrus, orbital part (Frontal_Mid_Orb_R) (p = 0.043), right inferior occipital gyrus (Occipital_Inf_R) (p = 0.003), and right middle temporal gyrus of the temporal pole (Temporal_Pole_Mid_R) (p = 0.003) in the BWTC group increased significantly; the fALFF values of the left middle frontal gyrus (Frontal_Mid_L) (p = 0.001) and right supplementary motor area (Supp_Motor_Area_R) (p = 0.010) in BWTC group decreased significantly. The fALFF values of Frontal_Mid_Orb_R were significantly positively correlated with the SDS score (r = 0.852, p = 0.015) and the fALFF values of Frontal_Mid_L were significantly negatively correlated with the SAS score (r = -0.797, p = 0.032). Conclusion: In this pilot study with college students, BWTC alleviated anxiety and depression, potentially through modulating activity in the Frontal_Mid_L and Frontal_Mid_Orb_R, respectively.

Stressors and symptoms associated with a history of adverse childhood experiences among older adolescents and young adults during the COVID-19 pandemic in Manitoba, Canada

INTRODUCTION

The COVID-19 pandemic has had major economic, social and psychological consequences for adolescents and young adults. It is unclear whether those with a history of adverse childhood experiences (ACEs) were particularly vulnerable. We examined whether a history of ACEs was associated with financial difficulties, lack of emotional support, feeling stressed/anxious, feeling down/depressed, increased alcohol and/or cannabis use and increased conflict with parents, siblings and/or intimate partners among 16- to 21-year-olds during the pandemic.

METHODS

Data were collected in November and December 2020 from respondents aged 16 to 21 years (n = 664) participating in the longitudinal and intergenerational Well-being and Experiences Study (Wave 3) conducted in Manitoba, Canada. Age-stratified associations between ACEs and pandemic-related stressors/symptoms were examined with binary and multinomial logistic regression.

RESULTS

A history of ACEs was associated with pandemic-related financial difficulties (adjusted relative risk ratio [aRRR] range: 2.44-7.55); lack of emotional support (aRRR range: 2.13-26.77); higher levels of feeling stressed/anxious and down/depressed (adjusted odds ratio [aOR] range: 1.78-5.05); increased alcohol and cannabis use (aOR range: 1.99-8.02); and increased relationship conflict (aOR range: 1.98-22.59). Fewer associations emerged for older adolescents and these were not to the same degree as for young adults.

CONCLUSION

Adolescents and young adults with a history of ACEs reported increased odds of pandemic-related stressors and symptoms, and may need more resources and greater support compared to peers without an ACE history. Differences in results for adolescents and young adults suggest that interventions should be tailored to the needs of each age group.

COPING STRATEGIES AND PSYCHOLOGICAL ADJUSTMENT TO THE COVID-19 PANDEMIC AMONG THE UKRAINIAN STUDENTS' YOUTH

OBJECTIVE

The aim: Establishment of emotional and behavioral ways of student response to the coronavirus pandemic, the assessment of dominant coping strategies, and the prevalence of neurotic states and stress among students.

PATIENTS AND METHODS

Materials and methods: The research used a specially developed questionnaire and a block of psychodiagnostic methods for diagnosing manifestations of neurotic conditions in students (Clinical questionnaire for the detection and assessment of neurotic conditions by K.K. Yakhin, D.M. Mendelevich), the level of psychological stress (Psychological Stress Scale PSM-25) and basic coping strategies (R. Lazarus' "Coping Strategies" questionnaire). The sample consisted of 213 respondents (119 girls, and 94 boys).

RESULTS

Results: Among Ukrainian students, the dominant reactions to the pandemic are depressive disorders, anxiety, and fears, a third of students self-reported autonomic disorders. The stress level is moderate. Girls react to the pandemic situation with more serious mental health disorders compared to boys. The use of all coping strategies was recorded at a high level of stress, which suggests that students have already exhausted their adaptation potential and are maladapted to the current conditions.

CONCLUSION

Conclusions: The study confirms the negative impact of the pandemic on the mental health of young people. The relationship between the type of response to the pandemic and the severity of neurotic disorders and stress was established. Available mental resources to cope with a difficult situation are exhausted, so students prefer to avoid and ignore stressful information. This creates the need for psychological support and educational activities regarding healthcare techniques.

The relationship between loneliness and depression among college students: Mining data derived from passive sensing

Background

While there is recognition of the relationship between loneliness and depression, specific behavioural patterns distinguishing both are still not well understood.

Objectives

Our objective is to identify distinct behavioural patterns of loneliness and depression from a passively collected dataset of college students, understand their similarities and interrelationships and assess their effectiveness in identifying loneliness and depression.

Methods

Utilizing the StudentLife dataset, we applied regression analysis to determine associations with self-reported loneliness and depression. Mediation analysis interprets the relationship between the two conditions, and machine learning models predict loneliness and depression based on behavioural indicators.

Results

Distinct behavioural patterns emerged: high evening screen time (OR = 1.45, p = 0.002) and high overall phone usage (OR = 1.50, p = 0.003) were associated with more loneliness, whereas depression was significantly associated with fewer screen unlocks (OR = 0.75, p = 0.044) and visits to fewer unique places (OR = 0.85, p = 0.023). Longer durations of physical activity (OR = 0.72, p = 0.014) and sleep (OR = 0.46, p = 0.002) are linked to a lower risk of both loneliness and depression. Mediation analysis revealed that loneliness significantly increases the likelihood of depression by 48%. The prediction accuracy of our XGBoost-based machine learning approach was 82.43% for loneliness and 79.43% for depression.

Conclusion

Our findings show that high evening screen time and overall phone usage are significantly associated with increased loneliness, while fewer screen unlocks and visits to fewer unique places are significantly related to depression. The findings can help in developing targeted interventions to promote well-being and mental health in students.

Exposure, perceived risk, and psychological distress among general population during the COVID-19 lockdown in Wuhan, China

Introduction

The COVID-19 pandemic that has been going on since the end of 2019 impacts people on both the physical and psychological levels. However, the psychological status, especially its underlying psychosocial mechanisms among the general population in Wuhan, the earliest epicenter and hardest-hit city in China during the pandemic, has not been well investigated. This study aimed to examine the relationships between exposures, perceived risk, and psychological distress among the general population in Wuhan during the COVID-19 lockdown.

Methods

Data were from a cross-sectional online survey conducted from 20 February to 4 March 2020. Final analyses included 4,234 Wuhan respondents. A 5-item Hopkins Symptom Checklist was adopted to assess respondents' psychological distress.

Results

It was found that nervousness, fear, and worry were the most common symptoms among Wuhan residents during the lockdown. Exposure within a close physical distance, exposure within the social network, and perceived risk are significantly positively related to respondents' psychological distress. Moreover, perceived risk mediated the effects of exposures on respondents' psychological condition.

Discussion

These findings conduce to identify the populations at higher risk of suffering psychological disturbance during the pandemic and are expected to inform the policymakers and mental health professionals to monitor and improve the perception of risk among the target population by appropriate interventions.

Associations between sedentary behavior and negative emotions in adolescents during home confinement: Mediating role of social support and sleep quality

BACKGROUND

Prolonged periods of sedentary behaviour, for instance, engendered by home confinement in Shenzhen city, has led to negative mental health consequences, especially in adolescents. Previous research suggests, in general, that sedentary behavior can increase negative emotions. However, the specific mechanism driving the relationship between sedentary behavior and negative emotions is still relatively unclear. Social support and sleep quality might partly explain the effect of sedentary behavior on negative emotions. Thus, the current study aimed to examine the associations between sedentary behavior and negative emotions, and to investigate if social support and sleep quality mediate such a relationship.

METHOD

During home confinement due to the COVID-19 Omicron variant outbreak, 1179 middle and high school students in Shenzhen were invited to voluntarily complete an e-questionnaire, including the 21-item Depression Anxiety Stress Scale (DASS-21), the short form of the International Physical Activity Questionnaire (IPAQ-SF), the Social Support Rating Scale (SSRS) and the Pittsburgh Sleep Quality Index (PSQI). Data from 1065 participants were included in the analysis.

RESULTS

We observed significant sex-related and demografic-related differences in emotional (e.g., anxiety, stress and social support) and other outcome variables (e.g., sitting duration and PSQI score). Furthermore, sedentary behavior, social support, and sleep quality were associated with negative emotions (p < .01), even after controlling for sex, age, only-child case, body mass index, and metabolic equivalent level. In addition, social support and sleep quality partially mediated the association between sedentary behavior and negative emotions.

CONCLUSION

The findings of the current study suggest that social support and sleep quality partially mediate the relationship between sedentary behavior and negative emotions in middle and high school students during home confinement in Shenzhen city.

Self-harm in Young People: Investigating the Role of Resilience and Posttraumatic Stress Related to the COVID-19 Pandemic

Evidence shows that young people may have experienced increased levels of posttraumatic stress and depression during the COVID-19 pandemic. However, the landscape on self-harm is still unclear. This study aimed to examine the role of COVID-19 related posttraumatic stress, depression and resilience as predictors of self-harm with and without suicidal intent. Participants were 625 young people aged 17-25 years old (M = 20.2 years, SD = 2.47). Resilience was measured using the self-reported Child & Youth Resilience Scale Measure - Revised (CYRM-R). Posttraumatic stress related to COVID-19 were measured using the Impact of Event Scale- Revised. Depression was measured using the depression subscale of the Depression, Anxiety and Stress Scale-21. Self-harm was evaluated with two dichotomous items. Participants reported high levels of depression and COVID-19 posttraumatic stress, and a significant percentage reported engaging in self-harm. Hierarchical logistic regressions showed that caregiver resilience decreased approximately 20% the odds of engaging in self harm with and without suicidal intent remaining a consistent predictor even after accounting posttraumatic stress and depression in the models. Posttraumatic stress and depression predicted a one-fold increase in the odds of engaging in self-harm with and without suicidal intent. However, posttraumatic stress was no longer a significant predictor when depression was entered in the model in self-harm without suicidal intent. The COVID-19 pandemic may have increased the likelihood of engaging in self-harm in young people. However, caregiver resilience seems to operate as a protective factor. This important finding carries implications beyond the context of the COVID-19 pandemic.

Links between mothers' ACEs, their psychopathology and parenting, and their children's behavior problems-A mediation model

Introduction

Children of mothers with a history of adverse childhoods are at greater risk of behavior problems. However, the mechanisms through which a mother's early adverse experiences (ACEs) are transmitted to her children need further study. Our goal was to examine a conceptual mediational model linking mothers' ACEs, maternal psychopathology symptoms, and parenting behaviors with children's internalizing and externalizing behaviors sequentially.

Methods

A sample of 153 Israeli mothers of children ages 3-12 (52% girls) participated in the study, and most of the mothers (94.7%) were cohabiting with a spouse. Mothers completed online questionnaires about their early adverse experiences, psychopathology symptoms, parenting behavior, and their children's internalizing and externalizing behavior.

Results

Results showed that mothers with higher ACE scores reported more maternal psychopathology symptoms and more internalizing behavior in their children. The mother's psychopathology in and of itself mediated the link between her ACEs and her child's internalizing and externalizing behavior. Moreover, an indirect sequential path emerged linking ACEs with the mother's psychopathology symptoms, which, in return, were linked with hostile parenting. Hostile parenting, in turn, was linked with children's internalizing and externalizing behavior.

Discussion

These findings highlight the complicated and intertwined ways in which adverse experiences early in the mother's life might put her child's wellbeing at risk. The findings suggest that ACEs are linked to maternal affect dysregulation, which interferes with parenting, increasing the risk of behavior problems in children. The findings underscore the need to assess mothers' adverse history, psychological distress, and parenting behavior, and provide treatments that can reduce the intergenerational transmission of early adverse experiences.

The effects of forest therapy on public mental health and circular economy: A policy support model in Japan

Background

Forest therapy has gained popularity in Japan and even other nations/regions due to its health benefits. In addition, forest therapy has contributed to the development of circular economy and industrial upgrading. Japanese successful practice can serve as a model for other countries in the Asia-Pacific region. To this end, the aim of this study was to determine whether forest therapy can improve the whole well-being of the participants and has a positive effect on the development of circular economy in the region.

Methods

Both empirical and inductive research methods were used; empirical approach was conducted to perform comparative analysis of regional data that was retrieved from the research project of Japanese Forestry Agency in 2015. Specifically, the efficacy of forest therapy on physical (blood glucose, blood pressure, body weight) and mental (sleep quality e.g.,) health outcomes among 815 participants was investigated. Regional data are from the statistics of Iiyama City from 1990 to 2005. After the concept of forest therapy became popular in the late 1990s, this element had a great positive impact on the economic benefits of Ishiyama City and other major forest scenic areas. We summarize and analyze a series of policies made by relevant departments of the Japanese government in the years from 2019 to 2021 to promote forest therapy and related circular industry development.

Results

Significant (pre-to-post participation) changes in physical measure was observed. Firstly, mean weight of those overweight participants decreased across three different time points (pre-test/enrollment = 79.7 kg, 3-month participation = 77.2, and 6-month participation = 76.8 kg), while overall mean weight of the participants decreased to 61, 60.5, and 60.4 kg, respectively. Secondly, Participant with normal weight showed a decrease on mean HbA1C (from 6.09 to 6.06) at Week 24, while overweight participants demonstrated a slight change 6.03-6.01 after 6 months the average HOMA-IR for overweight participants decreased from 3.5 to 2.5 at Week 24, while participants with normal weight demonstrated a decrease from 2.2 to 1.7 at Week 24. Forest Therapy has emerged in Japan since Mid-1990s and has attracted a large number of tourists all over the world due to its unique health benefits.

Conclusion

Forest therapy in Japan has positive effects on whole well-being of Japanese residents and it has helped public mental health promotion and economic growth. Under the guidance and support of government policies, it can promote the development of circular economy and industrial transformation and set a model of Japanese forest therapy development for other countries in the Asia-Pacific region.

Physical activity and mental health in sports university students during the COVID-19 school confinement in Shanghai

Background

In 2022, Shanghai was seriously affected by the coronavirus disease 2019 (COVID-19) pandemic. The government implemented citywide static management for 2 months, as well as all universities in Shanghai, which changed the normal learning and living style of sports students and led to a decline in physical activity level. As the physical activity has a strong correlation with mental health, this study aimed to investigate the current state of physical activity (PA) and mental health of the students in Shanghai University of Sport. It will try to reveal the correlation between PA and depressive symptoms, anxiety symptoms, fear of COVID-19 and smartphone addiction.

Methods

A cross-sectional survey was conducted on a random sample of 400 students who came from six different majors in May 2022 at the Shanghai University of Sport. Respondents completed the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Chinese version of the 9-item Patient Health Questionnaire (PHQ-9), the Chinese version of the Generalized Anxiety Disorder Scale (GAD-7), the Chinese version of the COVID-19 Fear Scale (FCV- 19S), and the Smartphone Addiction Scale (SAS-SV). Demographics, PA, depressive symptoms, anxiety symptoms, fear of COVID-19, and smartphone addiction were compared. A binary logistic regression model was used for the further analysis.

Results

A total of 376 college students were included in the final analysis. Binary logistics analysis showed that moderate physical activity (MPA) was negatively correlated with depression (OR = 0.95, 95%CI = 0.93-0.98), anxiety (OR = 0.97, 95%CI = 0.95-0.99), fear of COVID 19(OR = 0.99, 95%CI = 0.98-0.99)and smartphone addiction (OR = 0.94, 95%CI = 0.9-0.98) (all P < 0.05). Sedentary behavior was positively correlated with smartphone addiction (OR = 1.01, P < 0.01, 95%CI = 1.001-1.004).

Conclusion

There was an association between the presence of MPA and depressive symptoms, anxiety symptoms, fear of COVID-19, smartphone addiction, and sedentary behavior associated with smartphone addiction levels. Clarifying the causal relationship between PA and mental health will require further research.

Underpinning Chinese international students’ stress and anxiety during the first wave of COVID-19 outbreak: The moderating role of wisdom

During the first wave of the COVID-19 outbreak, the Chinese diaspora, especially Chinese international students, were subjected to greater stress than others, because they were under pressure from both fear of infection and coping with acculturation (e.g., discrimination). Consequently, more research is needed to understand the anxiety induced by COVID-19 stresses on this specific cultural group. The main purpose of this study is to investigate the relationship between COVID-19 stress and individuals’ anxiety, and the moderating roles of Acceptance, Reframing, and Striving (ARS) coping, the family support coping strategy, and wise reasoning. To test our predictions, we collected data from 224 Chinese international students (CIS). Results indicated a strong and positive relationship between pandemic stress and anxiety. Surprisingly, both ARS and family support coping did not moderate the association between COVID-19 stress and anxiety. Instead, wise reasoning as a potential reflective coping strategy interacted with COVID-19 stress to predict anxiety. Specifically, wise reasoning predicted more anxiety when individuals perceived a low-level of COVID-19 stress, however, such a relationship disappeared when individuals perceived a high-level of COVID-19 stress. These findings about wise-reasoning extends our understanding of wisdom and how it plays a role in the context of COVID-19.

Validation of the Hungarian Version of the COVID Stress Scale (CSS-H)

(1) Background: The COVID-19 pandemic is unprecedented and has affected every social class. The prevalence of moderate-to-severe stress and anxiety levels in the general population was reported to be 25%. This study aimed to describe the validation of the Hungarian version of the COVID Stress Scale. (2) Methods: The research study was a cross-section validation study with a representative sample (N = 1200) and a non-representative student sample (N = 350). The translation procedure was a four-step procedure. The interviewers conducted the data collection. (3) Results: The reliability of the Hungarian CSS was assessed using Cronbach's alpha. Convergent validity was evaluated by correlating the CSS with the PSS and WHO-WBI5. The Cronbach's alpha coefficient of the CSS-H factors was between 0.844 and 0.907 (representative sample) and between 0.878 and 0.936 (student sample), which qualified as very good. The reliability of the internal consistency was good for all six factors in both samples. The CSS-H total and all-domain scores significantly and positively correlated with the PSS total score and negatively correlated with well-being. (4) Conclusions: The Hungarian COVID Stress Scale is a valid, reliable instrument to measure COVID-19-related distress in the Hungarian population.

Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility

The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale-Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.

The mediating role of personal values between COVID-19-related posttraumatic growth and life satisfaction among Chinese college students: A two-wave longitudinal study

Despite considerable disruption of social order caused by the COVID-19 pandemic, it has also been said to contribute to positive psychological changes and influence on the perception of public life satisfaction. The present study aimed to explore the association between the COVID-19 related posttraumatic growth and life satisfaction and the mediating role of personal values. A two-wave longitudinal design was used. 226 self-quarantined Chinese college students (58.8% male) completed post traumatic growth inventory (Time 1), satisfaction with life scale (Time 2), personal values questionnaire (Time 2) between February 2020 and May 2021. Results showed that more than half of self-quarantined Chinese college students reported moderate to high levels of the COVID-19 related posttraumatic growth. A structural equation model revealed that COVID-19 related posttraumatic growth was positively associated to life satisfaction, and self-transcendence and self-enhancement values partially mediated this association. These findings shed light on whether and how pandemic-related posttraumatic growth influenced personal life satisfaction, supporting the outcome and process perspectives of posttraumatic growth as well as Schwartz’s value theory. Based on the findings, some positive psychology interventions, such as online rumination activities and mindfulness practice, were proposed to enhance self-quarantined college students’ posttraumatic growth and life satisfaction.

Tracing Chinese international students' psychological and academic adjustments in uncertain times: An exploratory case study in the United Kingdom

The worldwide spread of COVID-19 has exerted tremendous influences on the wellbeing of international students and the sustainable development of higher education. The current study adopts an 8-month exploratory case study to trace eight Chinese international students' psychological and academic adjustments in the United Kingdom amid the COVID-19 pandemic. Emerging from the qualitative data constitutive of semi-structured interviews, self-reflection writings, memoing, together with stimulated-recall interviews, findings have demonstrated the three main types of obstruction for such students' adjustments in the foreign land including COVID-specific challenges (i.e., the threat of infect, reduced access to university facilities and resources); COVID-enhanced challenges (i.e., anxiety exacerbated by parents and social media use, anti-Asian racism and hate incidents); and language barriers and cultural differences as long-standing issues. Students' previous lockdown experience, individual resilience, development of monocultural friendship patterns, and institutional provision and support are all factors that have contributed to their ability to overcome or at least mitigate the psychological and academic difficulties. The study offers insight into the impacts of COVID-19 on international students, providing implications that could contribute to the sustainable adjustments of international students in times of disruptive events and inform future responses to global health crises from individual and higher education perspectives.

The roles of exercise tolerance and resilience in the effect of physical activity on emotional states among college students

BACKGROUND/OBJECTIVE

Negative emotional states, such as depression, anxiety, and stress challenge health care due to their long-term consequences for mental disorders. Accumulating evidence indicates that regular physical activity (PA) can positively influence negative emotional states. Among possible candidates, resilience and exercise tolerance in particular have the potential to partly explain the positive effects of PA on negative emotional states. Thus, the aim of this study was to investigate the association between PA and negative emotional states, and further determine the mediating effects of exercise tolerance and resilience in such a relationship.

METHOD

In total, 1117 Chinese college students (50.4% female, Mage =18.90, SD=1.25) completed a psychosocial battery, including the 21-item Depression Anxiety Stress Scale (DASS-21), the Connor-Davidson Resilience Scale (CD-RISC), the Preference for and Tolerance of the Intensity of Exercise Questionnaire (PRETIE-Q), and the International Physical Activity Questionnaire short form (IPAQ-SF). Regression analysis was used to identify the serial multiple mediation, controlling for gender, age and BMI.

RESULTS

PA, exercise intensity-tolerance, and resilience were significantly negatively correlated with negative emotional states (Ps<.05). Further, exercise tolerance and resilience partially mediated the relationship between PA and negative emotional states.

CONCLUSIONS

Resilience and exercise intensity-tolerance can be achieved through regularly engaging in PA, and these newly observed variables play critical roles in prevention of mental illnesses, especially college students who face various challenges. Recommended amount of PA should be incorporated into curriculum or sport clubs within a campus environment.

Conservation of Resources, Psychological Distress, and Resilience During the COVID-19 Pandemic

Objectives: The Conservation of Resources (COR) theory suggests that stress results from threatened or actual loss of resources following significant life events. This study used COR theory as the framework to explore the reflection of loss of resources during the COVID-19 pandemic on psychological distress and resilience, in an adult Jewish Israeli population.

Methods: We examined the association between background variables, stress, loneliness, concern, COVID-19-related post traumatic symptoms (PTS), resilience factors and COR via an online survey among 2,000 adults during April 2020.

Results: Positive relationships were identified between resource loss and PTS (r = 0.66, p < 0.01), and between resource gain and resilience (r = 0.30, p < 0.01). Psychological variables were significantly associated with PTS and explained 62.7% of the variance, F (20, 1,413) = 118.58, p < 0.001.

Conclusion: Loss of resources, stress, loneliness and concern were found to be risk factors for distress and PTS, whereas resilience factors played a protective role. We thus recommend using the COR theory to explore COVID-19 effects elsewhere.

Negative emotions and creativity among Chinese college students during the COVID-19 pandemic: the mediating role of psychological resilience and the moderating role of posttraumatic growth

Background

The aim of the study was to use a moderated mediation model to understand and examine the relationship between negative emotions and creativity among college students during the COVID-19 pandemic, using psychological resilience as a mediator and posttraumatic growth as a moderator.

Methods

A sample of 881 college students in mainland China completed a self-report questionnaire that included four scales: the Depression-Anxiety-Stress Scale, Psychological Resilience Scale, Runco Ideational Behavior Scale and Posttraumatic Growth Inventory.

Results

Findings indicated that:(1) negative emotions were a strong predictor of creativity; (2) psychological resilience partially mediated the association between negative emotions and creativity; and (3) posttraumatic growth moderated the positive effect of psychological resilience, such that the indirect effect between negative emotions and creativity via psychological resilience was stronger for someone with a low level of resilience.

Conclusion

The findings further clarify the mechanisms that affect the relationship between negative emotions and creativity among college students.

Changes in Attachment to Parents and Peers and Relations With Mental Health During the COVID-19 Pandemic

Using a longitudinal design, we examined changes in parent and peer attachment among college students, and their predictive and protective roles in relation to mental health problems during the COVID-19 pandemic. College students (N = 106) rated their parent and peer attachment, and self-reported anxiety, loneliness, and depressive symptoms 1 year before and during the pandemic. Participants also rated the impact of COVID-19 related stressors (CRS). Results demonstrate significant increases in loneliness and depression and a decrease in peer attachment security during the pandemic. Increases in peer attachment security were negatively correlated with loneliness during the pandemic. Parent attachment buffered the relationship between the impact of CRS and mental health problems during the pandemic. Guided by the integrated framework from attachment theory and life course theory, the current study discussed findings and practices regarding the important role of attachment for college students and their adjustment to the pandemic.

Mental health conditions and academic burnout among medical and non-medical undergraduates during the mitigation of COVID-19 pandemic in China

The outbreak of the novel coronavirus disease 2019 (COVID-19) has posed a great impact on people's mental health, especially for undergraduate students. This study aimed to compare the mental health conditions and academic burnout between medical and non-medical undergraduates in China when the COVID-19 pandemic is mitigating. A cross-sectional online survey was conducted among 4,972 undergraduates between October 2020 and April 2021, when the pandemic was basically under control. The survey included basic demographics information and standardized scales to evaluate depression, anxiety, perceived stress, daytime sleepiness, alcohol abuse/dependence, quality of life, fatigue, and academic burnout. Compared with medical undergraduates, non-medical undergraduates had higher rates of moderate to severe depression symptoms (29.1% vs. 17.9%, P < 0.001), moderate to severe anxiety symptoms (19.7% vs. 8.9%, P < 0.001), alcohol abuse/dependence (16.3% vs.10.3%, P < 0.001), excessive daytime sleepiness (47.4% vs. 43.4%, P = 0.018), high perceived stress (34.7% vs. 22.2%, P < 0.001), high level of fatigue (51.8% vs. 42.2%, P < 0.001), low QOL (35.8% vs. 21.4%, P < 0.001), and higher academic burnout score (59.4 vs. 57.5, P < 0.001). Being non-medical undergraduates, depression, alcohol abuse/dependence, excessive daytime sleepiness, and high perceived stress were positively associated with academic burnout, while high QOL was negatively associated with the burnout (all P < 0.001). Excessive daytime sleepiness was the strongest predictor for academic burnout.

Identifying potential mechanisms between childhood trauma and the psychological response to the COVID-19 pandemic in Germany: a longitudinal study

Childhood maltreatment (CM) has been associated with adverse psychosocial outcomes during the pandemic, but the underlying mechanisms are unclear. In a prospective online study using baseline and 10-week follow-up data of 391 German participants, we applied multiple mediation analyses to test to what extent COVID-19 perceived stressors mediate the association between CM and later adverse psychosocial outcomes compared to established mediators of rumination and insecure attachment. We also explored the relative importance of different COVID-19 related stressors in predicting adverse psychological trajectories using elastic net regression. Results showed that CM was longitudinally associated with all adverse psychosocial outcome. COVID-19 perceived stressors, rumination, and insecure attachment mediated this relationship and full mediation was observed for the outcomes anxiety, stress and psychological well-being. COVID-19-related concerns about the future was most strongly and consistently associated with adverse psychosocial functioning. These findings provide preliminary evidence that COVID-19 perceived stressors, in particular concerns about the future, may be a key mechanism underlying the development of adverse psychosocial outcomes in individuals with a CM history. Thus, COVID-19 perceived stressors may require a higher priority for prevention and treatment efforts in vulnerable groups. Our results warrant replication in more representative cross-cultural samples.

Prospective examination of adolescent emotional intelligence and post-traumatic growth during and after COVID-19 lockdown

OBJECTIVES

While there have been some studies examining the post-traumatic growth (PTG) responses to the COVID-19 pandemic, few have been longitudinal studies exploring the changes over time or examining the underlying psychological PTG mechanisms. This study examined whether baseline perceived emotional intelligence (EI) predicted PTG through self-esteem and emotional regulation (ER) in a five-month follow-up study conducted on Chinese adolescents during the COVID-19 pandemic.

METHODS

Validated measures were completed by 2090 participants, which assessed both the perceived EI and the PTG 1 month after a nationwide lockdown in China, with 1609 of these participating in the follow-up five months later. Structural equation models (SEM) were then used to explore the paths between the variables.

RESULTS

As hypothesized, the follow-up survey found that the baseline perceived EI predicted PTG, ER, and self-esteem outcomes. The SEM analyses also revealed that self-esteem and ER significantly mediated the association between EI and PTG.

LIMITATIONS

Studies of three or more waves may be more suitable for longitudinal mediation analyses. Self-assessment reports may have subjective effects.

CONCLUSIONS

It was concluded that perceived EI might improve PTG in adolescents following the COVID-19 pandemic, and self-esteem and ER program training could be helpful in promoting PTG.

The Psychological Impact of the COVID-19 Pandemic on Postsecondary Students: An Analysis of Self-Determination

The COVID-19 pandemic has put postsecondary students across the world at risk of psychological distress, negatively impacting their basic psychological well-being, including self-determination. Although the concept of self-determination has been widely discussed in literature, it is poorly understood within the context of postsecondary students during the COVID-19 pandemic. This study aimed to examine the concept of self-determination (SD) as it relates to postsecondary students amid the COVID-19 pandemic. The Rodgers' evolutionary method of concept analysis was used. PubMed, CINAHL, PsycINFO, and ERIC were electronically searched using the keywords "postsecondary students" "coronavirus pandemic" and "self-determination." The historical, legal, educational, and health science literature were investigated to generate a holistic definition of SD in the past. This analysis has identified the antecedents, attributes, and consequences of self-determination in postsecondary students during this global health crisis. This analysis adds to the knowledge base regarding the evolution, significance, and application of the concept of SD in the context of postsecondary students amidst the COVID-19 pandemic. Implications for future research were also explored, such as using strategies to promote SD in postsecondary students to develop resilience during the pandemic.

Risks and Resources for Depressive Symptoms and Anxiety in Children and Adolescents During the COVID-19 Pandemic - Results of the Longitudinal COPSY Study

Background

Mental health during the COVID-19 pandemic is of particularly high relevance. Especially for children and adolescents, the pandemic and its restrictions represent a significant burden. The present study aims to identify risks and resources for depressive symptoms and anxiety in children and adolescents during the pandemic in Germany.

Materials and Methods

Self-reported data from the first wave of the longitudinal COVID-19 and Psychological Health (COPSY) study were used to investigate risks and resources among n = 811 children and adolescents aged 11-17 years. Depressive symptoms and anxiety were measured at the first follow-up 6 months later. Multivariate linear regression analyses were performed to investigate the effects of risks and resources on depressive symptoms and anxiety.

Results

Parental depressive symptoms predicted depressive symptoms and anxiety in children and adolescents 6 months later. Female gender was identified as a risk factor for anxiety during the pandemic. None of the potential resources were associated with depressive symptoms or anxiety at the follow-up.

Conclusion

The findings provide evidence of risk factors for depressive symptoms and anxiety during the COVID-19 pandemic. Children and adolescents who face risk factors need to be identified early and monitored during the pandemic. Family-based intervention programs are needed to help vulnerable children and adolescents cope with the challenges of the pandemic.

Disentangling the associations between past childhood adversity and psychopathology during the COVID-19 pandemic: The mediating roles of specific pandemic stressors and coping strategies

BACKGROUND

Individuals with a history of adverse childhood experiences (ACEs) display heightened symptoms of psychopathology during the COVID-19 pandemic. Yet, no study has investigated what aspects of the pandemic are of particular concern for this population and ways in which strategies to coping with pandemic stressors may exacerbate their clinical symptomatology.

OBJECTIVE

This study explores what pandemic stressors and coping strategies are associated with ACEs, depression, and posttraumatic stress disorder (PTSD) during the COVID-19 pandemic, before investigating whether the identified chief stressors and coping styles mediate the effects of ACEs on depression and PTSD.

PARTICIPANTS AND SETTING

1107 Greek adults were sampled from the general population.

METHODS

Participants completed the Adverse Childhood Experiences Questionnaire, Patient Health Questionnaire, Primary Care PTSD Screen for DSM-5, Pandemic Stressor Scale, and Brief Cope Scale.

RESULTS

ACEs and depression were both predominantly associated with difficult housing conditions as a stressor (b = 0.079, p < .001 and b = 0.046, p < .001, respectively), whereas PTSD was mainly related to fear of contracting the COVID-19 virus (b = 0.065, p < .001). Self-blame was the main coping strategy associated with both ACEs (b = 0.046, p = .010), depression (b = 0.071, p < .0005), and PTSD (b = 0.088, p < .0005). Difficult housing conditions and self-blame further demonstrated a significant serial mediation effect in the relationship between ACEs with both depression (b = 0.105, 95% CI [0.0607, 0.158]) and PTSD (b = 0.019, 95% CI [0.011, 0.031]).

CONCLUSIONS

The findings indicate that policy makers should identify ways of ameliorating challenging housing conditions, and that service providers should target self-blame in the psychological treatment of adults with ACEs during the COVID-19 pandemic.

Lifestyle behaviours and mental health and wellbeing of tertiary students during COVID-19 lockdown in Australia: A cross-sectional study

BACKGROUND

Australia experienced significant COVID-19 lockdown restrictions throughout 2020 that had an impact on mental health and disrupted health-promoting lifestyle behaviours. Lockdowns may have exacerbated existing mental health concerns among tertiary students, who experience higher levels of mental health concerns compared to the wider community. This study aimed to investigate the association between modifiable lifestyle factors and wellbeing of students at a Melbourne-based tertiary education institution during COVID-19 lockdown.

METHODS

This quantitative, cross-sectional study was conducted across campuses in Melbourne and Sydney. Data was collected via online questionnaire during the 7th week of a second-wave lockdown. Descriptive statistics were calculated for demographic variables (n = 239). Linear regression models were estimated to determine multivariate associations between lifestyle variables and psychological distress.

RESULTS

Participants were on average 30.98 years old (SD = 9.78), predominantly female, domestic students, undergraduate, not the first member of their family to attend university and living out of family home. Mindfulness, diet quality, sleep quality and moderate-vigorous physical activity (MVPA) were all inversely correlated with psychological distress. Unadjusted and adjusted models show that mindfulness, sleep quality, and MVPA were all independently inversely related to psychological distress. Greater mindfulness, sleep quality and engagement in MVPA were associated with lower psychological distress during COVID-19 lockdowns.

LIMITATIONS

As this study is cross-sectional and we cannot rule out reverse causality.

CONCLUSION

This study highlights the potential for lifestyle focused mental-health promotion delivered through tertiary education institutions to support students in times of crisis as well as more generally.

Prevalence of Post-Traumatic Stress Disorder (PTSD) in University Students during the COVID-19 Pandemic: A Meta-Analysis Attending SDG 3 and 4 of the 2030 Agenda

Background: Most universities around the world have been heavily affected by the COVID-19 pandemic, as declared by the World Health Organization (WHO) in March 2020. Many students were isolated at home and underwent a forced transition from face-to-face learning to e-learning, at least in the first few months. The subsequent months and years were typically characterised by a slow return to normal learning under COVID-19 protocols and restrictions. A potential consequence of the lockdowns, social restrictions and changes to learning is the development of PTSD (post-traumatic stress disorder) in university students, affecting their health and well-being (SDG3) and quality of education (SDG4). Materials and Methods: Medline was searched through PubMed for studies on the prevalence of PTSD in university students from 1 December 2019 to 31 December 2021. The pooled prevalence of PTSD was calculated with random-effects models. Results: A total of six studies were included, across which the prevalence of PTSD among university students was 23%. Meta-regression showed that the prevalence of PTSD was significantly higher with older age, but independent of the percentage of women in a study or its methodological quality. Conclusions: Our results suggest that students suffer from PTSD at a moderate rate. Measures are needed to address the mental health issues of university students that have arisen during COVID-19 all around the world.

Role of positive mental health in reducing fears related to COVID-19 and general anxiety disorder in Khyber Pakhtunkhwa, Pakistan

Background

The outbreak of the novel coronavirus disease (COVID-19) has posed multiple challenges to healthcare systems. Evidence suggests that mental well-being is badly affected due to compliance with preventative measures in containing the COVID-19 pandemic. This study aims to explore the role of positive mental health (subjective sense of wellbeing) to cope with fears related to COVID-19 and general anxiety disorder in the Pashtun community in Pakistan.

Methods

A cross-sectional survey was conducted among 501 respondents from Khyber Pakhtunkhwa participating in an online-based study. We performed correlational analysis, hierarchical linear regression and structural equational modeling (SEM) to analyze the role of mental health in reducing fears and general anxiety disorder.

Results

The results of the SEM show that positive mental health has direct effects in reducing the fear related to COVID-19 (β = − 0.244, p < 0.001) and general anxiety (β = − 0.210, p < 0.001). Fears of COVID-19 has a direct effect on increasing general anxiety (β = 0.480). In addition, positive mental health also has an indirect effect (β = − 0.117, p < 0.001) on general anxiety (R² = 0.32, p < 0.001) through reducing fear of coronavirus.

Conclusion

Based on these findings, there is a need to develop community health policies emphasizing on promotive and preventive mental health strategies for people practicing social/physical distancing.

Evaluation of Expressive Arts Therapy on the Resilience of University Students in COVID-19: A Network Analysis Approach

As an alternative to traditional verbal counselling, expressive arts therapy has been shown to be an effective method of mental health care, particularly when dealing with stressful public interactions, such as those associated with COVID-19. However, few studies have been conducted to determine the efficacy of expressive arts therapy on the resilience of psychologically exposed university students during COVID-19. Furthermore, since network analysis appears to be a popular approach in psychological research, it has not been used in recent intervention studies for resilience. As a result, the current study utilized a network analysis approach to determine the efficacy of expressive arts therapy on the resilience of university students during the COVID-19 pandemic. A total of 263 students in a comprehensive university in China were selected for the therapy group between March and November 2021. In a pre-post design, students’ resilience was assessed using the Resiliency Scale for University Students (RSUS). The extended Bayesian information criteria (EBIC) and graphical LASSO were used to estimate and define paired resilience networks, and the strength, betweenness, and closeness indices were utilized to determine the centrality of the six facets of resilience. Additionally, we verified the stability and accuracy. It was discovered that significant differences appeared between the paired networks before and after expressive arts therapy. Facets of self-efficacy, self-acceptance and problem-solving in resilience were notably improved after the therapy, with the variable of emotional stability sustained at the mean level. Meanwhile, the network analysis has highlighted the central variable of self-efficacy in the pre-intervention and support from friends in the post-intervention. The connectivity among the components of problem solving, support from friends, and support from family was enhanced, with support from friends playing the role of hub nod in the following network. By utilizing a network analytic approach, expressive arts therapy can be more targeted in intervening in resilience mechanisms. As a proxy for efficacious problem-solving, intervention should be calibrated to the cultivation of social support networks, especially in the support from friends.

Medical Students and Professionals Facing the COVID-19 Pandemic: A Cross-Sectional Survey Study about Similarities and Differences

This study aimed at exploring the emotional reaction that medical students (MS) and professionals have faced during the COVID-19 pandemic and investigating the differences between the two groups. A total of 362 MS and 330 professionals filled in an online survey during the second outbreak of the COVID-19 pandemic in Italy. The outcome measures were psychological distress with the General Health Questionnaire, stress, fear for themselves, fear for family members and cohabitants, perceived control, anger, loneliness, and feeling abandoned by institutions with Visual Analog Scales (VAS) and two open-ended questions about their perceived difficulties and the perceived consequences of the pandemic. The results showed that the level of distress among the two groups was above the threshold (MS mean: 21.85; professionals mean: 21.25). The means of the VAS of MS and professionals showed different results for the two groups, and we analyzed them with independent samples t-tests and linear regressions. MS reported higher levels of perceived loneliness (t(673.177) = −1.970, p < 0.05), while physicians reported more fear for themselves (t(655.183) = 4.799, p < 0.001), anger (t(690) = 2.096, p < 0.05), and feeling abandoned by the institutions (t(690) = 7.296, p < 0.001). The open questions were analyzed considering the most frequent words used to describe their perceived difficulties and consequences; the specificity analysis emphasizes the differences in the words used by the two groups. In conclusion, MS and physicians reported similar levels of psychological symptoms. Physicians were mostly worried about themselves, they were afraid of getting infected, while MS suffered from loneliness and the missed possibilities concerning their education.

Longitudinal Predictors of Coronavirus-Related PTSD among Young Adults from Poland, Germany, Slovenia, and Israel

The aim of this study was to reveal longitudinal predictors of coronavirus-related PTSD and the moderating roles of country, sex, age, and student status among young adults from Poland, Germany, Slovenia, and Israel. We included the following predictors: perceived stress, exposure to COVID-19, perceived impact of COVID-19 on well-being in socioeconomic status (PNIC-SES) and social relationships (PNIC-SR), fear of COVID-19, fear of vaccination, and trust in institutions. We conducted the study online among a representative sample of 1723 young adults aged 20-40 (M = 30.74, SD = 5.74) years in February 2021 (T1) and May-June 2021 (T2). We used McNemar's χ2 and the paired samples Student's t-test to test differences over time. We assessed the relationships between variables using Pearson's correlation. We performed structural equation modeling (SEM) to examine the associations between variables at T1 and T2. We used a lagged regression model to examine the causal influences between variables across different time points (T1 and T2). The results showed that all variables decreased over time, except exposure to COVID-19. The rates of infected, tested, and under-quarantine participants increased. The rates of those who lost a job and experienced worsening economic status decreased. The rate of hospitalized participants and those experiencing the loss of close ones did not change. Higher perceived stress, fear of COVID-19, fear of vaccination, and trust in institutions were significant longitudinal predictors of coronavirus-related PTSD regardless of country, sex, age, and student status. Institutions should provide more accurate programs for public health, so trust in institutions can be a protective and not a risk factor in future traumatic events.

Impacts of the psychological stress response on aggression in adolescents during the COVID-19 epidemic in China

The sudden outbreak of COVID-19 has exerted a tremendous impact on the psyche of people around the world, especially adolescents. In order to provide a valuable theoretical basis for effective measures to prevent psychological problems in adolescents during public health emergencies in the future, this study examined the mediating effect of coping style (CS, including positive coping style (PCS) and negative coping style (NCS)) and the moderating effect of emotional management ability (EMA) on the relationship between the psychological stress response (PSR) and aggression (AGG) in adolescents during the COVID-19 epidemic in China. The Buss–Warren Aggression Questionnaire, Simplified Coping Style Questionnaire, and Emotion Management Questionnaire were employed to investigate the mental health of Chinese adolescents from April 10–20 (Time point 1, T1) and May 20–30 (Time point 2, T2), 2020. A total of 1,931 adolescents (aged 10–25 years, M = 19.18 years, 51.4% male) were examined at T1 and 334 adolescents (aged 11–25 years, M = 19.97 years, 48.7% male) were reinvestigated at T2. Overall, 17.6% of the participants at T1 and 16.8% at T2 reported obvious PSR activation. NCS partly mediated the relationship between the PSR and AGG, and the indirect effect was moderated by EMA reported at T2. There were regional differences in the moderated mediation model in low-risk areas at T1. The moderated effects of EMA at T1 and T2 were opposite. Specifically, high EMA resulted in a stronger relationship between NCS and AGG at T1, whereas high EMA resulted in a weaker relationship between NCS and AGG at T2. Psychological reactions resulting from sudden public health events may trigger AGG in younger individuals. However, EMA may have a buffering effect on the onset of AGG. This research expands our understanding of the development of AGG in adolescents during the pandemic.

A Positive Psychology Resource for Students? Evaluation of the Effectiveness of the 6 Minutes Diary in a Randomized Control Trial

This study investigated the effects of the 6 Minutes Journal (6MT), a commercial diary combining several positive psychology interventions, including gratitude, goal-setting, and self-affirmation exercises, on several mental health outcome measures. In a randomized controlled trial, university students (N = 157) were randomly assigned to one of two groups: 6MT (n = 77) and a wait list control group (n = 80). Participants in the intervention group were instructed to follow the instructions of the 6MT for 4 weeks. Participants in both groups completed measures of perceived stress, positive and negative affect, self-efficacy and resilience at baseline, after 2 (t1), and 4 (t2) weeks. We used path-analyses with autoregressive and cross-lagged effects to test our hypotheses of the effects of the 6MT. Participants in the intervention group reported decreased levels of perceived stress and negative affect, as well as increased levels of resilience and self-efficacy compared to the control group. Positive affect was not statistically significantly influenced. The data showed a statistically significant increased levels of self-efficacy and resilience only after 4 weeks, suggesting that changing these constructs needs more time. The 6-minute diary does not appear to make individuals fundamentally more positive. However, the intervention may have a protective function against negative influences on well-being.

Prevalence and associated factors of suicidal ideation among college students during the COVID-19 pandemic in China: a 3-wave repeated survey

OBJECTIVE

The coronavirus disease 2019 (COVID-19) pandemic, a major public health crisis, harms individuals' mental health. This 3-wave repeated survey aimed to examine the prevalence and correlates of suicidal ideation at different stages of the COVID-19 pandemic in a large sample of college students in China.

METHODS

Using a repeated cross-sectional survey design, we conducted 3 online surveys of college students during the COVID-19 pandemic at 22 universities in Guandong, China. The 3 surveys were conducted during the outbreak period (T1: 3 February to 10 February 2020, N = 164,101), remission period (T2: 24 March to 3 April 2020, N = 148,384), and normalized prevention and control period (T3: 1 June to 15 June 2020, N = 159,187). Suicidal ideation was measured by the ninth item of the Patient Health Questionnaire-9. A range of suicide-related factors was assessed, including sociodemographic characteristics, depression, anxiety, insomnia, pre-existing mental health problems, and COVID-19-related factors.

RESULTS

The prevalence of suicidal ideation was 8.5%, 11.0% and 12.6% at T1, T2, and T3, respectively. Male sex (aOR: 1.35-1.44, Ps < 0.001), poor self-perceived mental health (aOR: 2.25-2.81, Ps < 0.001), mental diseases (aOR: 1.52-2.09, P < 0.001), prior psychological counseling (aOR: 1.23-1.37, Ps < 0.01), negative perception of the risk of the COVID-19 epidemic (aOR: 1.14-1.36, Ps < 0.001), depressive symptoms (aOR: 2.51-303, Ps < 0.001) and anxiety symptoms (aOR: 1.62-101.11, Ps < 0.001) were associated with an increased risk of suicidal ideation.

CONCLUSION

Suicidal ideation appeared to increase during the COVID-19 pandemic remission period among college students in China. Multiple factors, especially mental health problems, are associated with suicidal ideation. Psychosocial interventions should be implemented during and after the COVID-19 pandemic to reduce suicide risk among college students.

The Psychological Well-Being of University Students amidst COVID-19 Pandemic: Scoping review, systematic review and meta-analysis

This review aimed to summarise the current evidence relating to university students' psychological well-being amidst the COVID-19 pandemic. A scoping review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, was first conducted to determine if the evidence can be systematically reviewed and meta-analysed. The search was performed via Google Scholar, MEDLINE/PubMed, Science Direct, Scopus and Web of Science. A total of 90 original articles were selected for the scoping review. Meta-analysis of a total of 46,284 cases revealed an overall pooled prevalence rate of 29.1% (95% confidence interval [CI]: 20.9-39.0; K = 9, N = 22357) for anxiety symptoms and 23.2% (95% CI: 15.7-32.9; K = 12, N = 23927) for depression symptoms. This data revealed that COVID-19 had a significant impact on university students' psychological well-being.

Virtual Reality (VR) Technology for Treatment of Mental Health Problems during COVID-19: A Systematic Review

There was a surge in psychological distress and emotional burnout during the COVID-19 pandemic. Virtual reality (VR) is helpful as a psychological intervention whilst maintaining physical or social distancing. The present systematic review assessed the role of VR as a psychological intervention tool for mental health problems during the COVID-19 pandemic. We conducted a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This study used the search-related terms: (Virtual reality OR simulated-3D-environment OR VR) AND (covid! or corona!) AND (mental* OR psychologic* OR well* OR health*) AND (intervention) on six databases, i.e., MEDLINE, PsycINFO, Ovid Medline, EMBASE, ACM digital library, and Cochrane Central Register of Controlled Trials (CENTRAL) from the inception date until 23 June 2021. We finally included four studies in the systematic review out of the 379 references imported for screening. These studies reveal that VR is beneficial as a psychological tool for intervention in individuals with mental health problems. Immersed in the telepresence, interacting in a 3-D format compared to a 2-D layout, having a sense of enjoyment and engagement, activating an affective-motivational state, “escaping” to a virtual from the real world are pivotal faucets of VR as a psychological tool for intervention.

A Cross-sectional Study of the Mental Health Symptoms of Latin American, US Hispanic, and Spanish College Students Amid the COVID-19 Pandemic

Young adults and racial/ethnic minorities report the worst mental health outcomes during the COVID19 pandemic, according to the Center for Disease Control (2020). The objectives of this study were (1) to identify common mental health symptoms among Latin American, US Hispanic, and Spanish college students, and (2) to identify clinical features predictive of higher post-traumatic stress symptoms (PTSS) among this population. The study sample included 1,113 college students from the USA, Mexico, Chile, Ecuador, and Spain who completed an online survey containing demographic questions and mental health screeners. Findings revealed higher scores of depression, suicidality, and PTSS compared to pre-pandemic levels and current scores by non-Spanish speaking college students; however, less than 5% of participants endorsed clinical levels of anxiety. After controlling for demographic profiles and sociocultural values, clinical symptoms of depression, loneliness, perceived stress, anxiety, and coping strategies explained 62% of the PTSS variance. Age, history of mental illness, perceived social support, and familism were not significant predictors. This sample of college students revealed higher mental health symptoms during the COVID-19 pandemic. The high prevalence of PTSS highlights the need to develop pragmatic, cost-effective, and culturally sensitive prevention and intervention strategies to mitigate these symptoms. Implications for college administrators and clinicians are discussed.

The Impact of Intrusive Rumination on College Students’ Creativity During the COVID-19 Pandemic: The Mediating Effect of Post-traumatic Growth and the Moderating Role of Psychological Resilience

Purpose

College students in the pandemic area are experiencing the problems caused by COVID-19 by themselves or people around them, how to cope with the sudden changes and adjust the psychological stress response, and get experience and grow in the fight against the pandemic is a question worth in-depth discussion. The researchers constructed a mediated regulation model to examine the effects of intrusive rumination on the creativity of college students during the COVID-19 pandemic, as well as the mediating effect of post-traumatic growth and the moderating role of psychological resilience.

Methods

A sample of 475 university students from Guangdong Province, China, were surveyed with the Runco Ideational Behavior Scale, the Event Related Rumination Inventory, the Posttraumatic Growth Inventory, and the Psychological Resilience Scale. SPSS (version 23) and PROCESS (version 3.3) were used for correlation analysis, mediation analysis, and mediated moderation analysis.

Results

(1) Intrusive rumination was positively correlated with post-traumatic growth and creativity but negatively correlated with psychological resilience. Psychological resilience was positively correlated with post-traumatic growth and creativity. Post-traumatic growth and creativity were positively correlated. (2) Post-traumatic growth played a mediating role in the relationship between intrusive rumination and creativity. (3) Psychological resilience moderated the first half of the pathway “intrusive rumination → post-traumatic growth → creativity.”

Conclusion

Intrusive rumination affected creativity directly and also indirectly through post-traumatic growth. At the same time, psychological resilience played a moderating role between intrusive rumination and creativity. The correlation between intrusive rumination and post-traumatic growth was stronger when levels of psychological resilience levels were higher.

Post-traumatic Growth and Psychological Resilience During the COVID-19 Pandemic: A Serial Mediation Model

Although the World Health Organization (WHO) has issued guidelines for managing to contain, mitigate, and limit of the COVID-19. However, it is more essential to highlight the urgency and importance of evaluating social functioning and mental health status during the pandemic. College students have experienced serious problems and have had to overcome many negative situations brought about by the pandemic. Accordingly, the present study intended to use Chinese college students as sample to examine the positive adoption and changes during the ongoing COVID-19. Guided by literatures in this filed, we explored the internal mechanism of post-traumatic growth affecting psychological resilience, and considered about mediation roles of positive coping styles and cognitive reappraisal. A total of 463 college students from universities in China effectively completed online questionnaires. The result indicated that these four variables were positively correlated with each other (ps < 0.001). More importantly, our findings proved a direct and positive effect on psychological resilience. Positive coping styles and cognitive reappraisal, respectively, mediated the relationship between post-traumatic growth and psychological resilience. Over all, the hypothesized serial model conclusively fits the data: students with high-level post-traumatic growth tended to report increased use of positive coping strategies, which further facilitated their cognitive reappraisal, and subsequently, promoted their psychological resilience. The findings obtained in this study will provide a theoretical basis and possible viable strategies for both targeted crisis intervention and psychological trauma recovery plans.

Mediation-Moderation Links Between Mothers' ACEs, Mothers' and Children's Psychopathology Symptoms, and Maternal Mentalization During COVID-19

Research has suggested adverse childhood experiences (ACEs) as a transdiagnostic risk factor for a variety of affective disorders. They are also linked with a parent's tendency toward affect dysregulation and hyperarousal, which may interfere with parenting and children's wellbeing. On the other hand, maternal mentalization can serve as a moderating factor that can help parents regulate their arousal, shielding children during adverse circumstances. We studied the mediated links between ACEs and mothers' and children's psychopathology symptoms during COVID-19 to determine whether maternal mentalization and the child's age moderate these links. Using results from 152 Israeli mothers of children aged 3-12 years recruited during the month-long lockdown in Israel, we documented that the mothers' ACEs were linked with increased risk of depressive and anxiety symptoms and with children's internalizing and externalizing behaviors. Moreover, as hypothesized, the mothers' symptoms of depression and anxiety mediated the links between their ACEs and their children's internalizing behaviors. In addition, the mothers' mentalization skills and, in the case of their depressive symptoms, their child's age, moderated these indirect links. For mothers of young children (3-6 years old) with higher mentalization levels, the link between the mothers' ACEs and the children's behavior problems was weaker compared to mothers with low mentalization levels. For mothers of older children (6-12 years old), and only in the case of maternal depressive symptoms, higher levels of maternal mentalization were linked with more internalizing behaviors. We discuss the potential clinical implications of the findings.

Pandemic Exposure, Post-traumatic Stress Disorder, Conflict Behaviors, and Online Aggressive Behaviors Among College Students During the COVID-19 Pandemic: Examining the Moderating Role of Gender

The COVID-19 pandemic impacts people's mental health and behaviors, but the influence mechanism between pandemic exposure, conflict behaviors, and online aggressive behaviors during the COVID-19 outbreak remains unclear. This study will address this gap. Data were collected from 1,153 college students in an online survey that included an pandemic experiences scale, a post-traumatic stress disorder (PTSD) scale, a conflict behaviors scale, and an online aggressive behaviors scale. Structural equation modeling and multi-group comparisons were used to analyze the data. Pandemic exposure positively predicted conflict and online aggressive behaviors through hyperarousal symptoms, and negatively predicted these behaviors through intrusive symptoms. The mediating roles of avoidance and negative alterations in cognition and mood symptoms in the relations between pandemic exposure and conflict behaviors and online aggressive behaviors were non-significant. Among male students, pandemic exposure directly predicted conflict and online aggressive behaviors, but for female students, pandemic exposure indirectly influenced these behaviors through intrusive and hyperarousal symptoms. The intrusive and hyperarousal symptoms play mediating roles in the relations between pandemic exposure and conflict behaviors and online aggressive behaviors. Gender plays a moderating role in the above mediating mechanism.

Global research on syndemics: a meta-knowledge analysis (2001-2020)

BACKGROUND

Syndemics or synergies of cooccurring epidemics are widely studied across health and social sciences in recent years.

METHODS

We conducted a meta-knowledge analysis of articles published between 2001 to 2020 in this growing field of academic scholarship.

RESULTS

We found a total of 830 articles authored by 3025 authors, mostly from high-income countries. Publications on syndemics are gradually increasing since 2003, with rapid development in 2013. Each article was cited more than 15 times on average, and most (n = 604) articles were original studies. Syndemics research focused on several areas, including HIV/AIDS, substance abuse, mental health, gender minority stressors, racism, violence, chronic physical and mental disorders, food insecurity, social determinants of health, and coronavirus disease 2019. Moreover, biopsychosocial interactions between multiple health problems were studied across medical, anthropological, public health, and other disciplines of science.

CONCLUSIONS

The limited yet rapidly evolving literature on syndemics informs transdisciplinary interests to understand complex coexisting health challenges in the context of systematic exclusion and structural violence in vulnerable populations. The findings also suggest applications of syndemic theory to evaluate clinical and public health problems, examine the socioecological dynamics of factors influencing health and wellbeing, and use the insights to alleviate health inequities in the intersections of synergistic epidemics and persistent contextual challenges for population health.

Global research on syndemics: a meta-knowledge analysis (2001-2020)

BACKGROUND

Syndemics or synergies of cooccurring epidemics are widely studied across health and social sciences in recent years.

METHODS

We conducted a meta-knowledge analysis of articles published between 2001 to 2020 in this growing field of academic scholarship.

RESULTS

We found a total of 830 articles authored by 3025 authors, mostly from high-income countries. Publications on syndemics are gradually increasing since 2003, with rapid development in 2013. Each article was cited more than 15 times on average, and most (n = 604) articles were original studies. Syndemics research focused on several areas, including HIV/AIDS, substance abuse, mental health, gender minority stressors, racism, violence, chronic physical and mental disorders, food insecurity, social determinants of health, and coronavirus disease 2019. Moreover, biopsychosocial interactions between multiple health problems were studied across medical, anthropological, public health, and other disciplines of science.

CONCLUSIONS

The limited yet rapidly evolving literature on syndemics informs transdisciplinary interests to understand complex coexisting health challenges in the context of systematic exclusion and structural violence in vulnerable populations. The findings also suggest applications of syndemic theory to evaluate clinical and public health problems, examine the socioecological dynamics of factors influencing health and wellbeing, and use the insights to alleviate health inequities in the intersections of synergistic epidemics and persistent contextual challenges for population health.

The relationship between health-related quality of life of students at Tehran University of Medical Sciences and their knowledge, attitudes, and practices regarding COVID-19 in 2020

BACKGROUND

Present study attempts to investigate health-related quality of life (HRQoL) and its relation with knowledge, attitudes, and practices (KAP) of students of Tehran University of Medical Sciences (TUMS) during this pandemic.

MATERIALS AND METHODS

In this cross-sectional study which was conducted between 23 may to 21 June 2020, 470 students in different levels of TUMS were included to the study randomly. participants completed validate, designed online questionnaire which assessed KAP towards coronavirus disease 2019 (COVID-19) and HRQoL. All statistical tests were applied, including Chi-square and Fisher's exact test, Partial correlation, analysis of variance, multiple linear regression, multiple binary and multinomial logistic regression models (P < 0.05) and were performed in SPSS 16, R 4.0.2, and GraphPad Prism 6.0 softwares.

RESULTS

A total of 470 students were included in the study. The overall correct answer rate of the COVID-19 knowledge questionnaire was 74.43% and total score of the HRQoL was 72.50 (14.85). 61.7% of the students were agreed that COVID-19 will finally be successfully controlled, 44.3% had confidence that Iran can win the battle against the COVID-19, and 92.6% agreed that Quarantine will reduce the prevalence of COVID-19. Most of them adhered to health protocols and about a relation between HRQoL and knowledge we have a weak positive and unsignificant correlation between them (r = 0.05, P = 0.27).

CONCLUSIONS

TUMS students showed expected levels of knowledge, proper attitudes, and preemptive practices regarding COVID-19, whereas COVID-19 outbreak substantially affected the physical and mental health but, the students were in a way better physical health rather than mental. Therefore, motivational planning and other related intervention to improve mental health can be noticeable.

The Role of Virtual Reality as a Psychological Intervention for Mental Health Disturbances during the COVID-19 Pandemic: A Narrative Review

The COVID-19 pandemic spread throughout the world and created many problems. The COVID-19 pandemic caused an increase in mortality and morbidity, including mental health problems. Around the world, the movement control order (MCO) was strictly enforced, but the spread of the infection epidemic was still rampant. The magnitude of the increase in mental health illnesses has caused many individuals to suffer. Given that face-to-face interventions are challenging to carry out during an outbreak, we need to address this critical problem through an online approach, such as virtual reality (VR). This approach is vital to helping patients deal with their existing problems in more pragmatic, practical, and customer-friendly ways. Thus, in the present review, we proposed the development of a virtual digital device for this noble purpose. Various challenges, improvements, and expectations for VR applications were outlined and discussed in this narrative review.

Psychological impact during COVID-19 pandemic: A web-based cross-sectional study among students studying at College of Science and Technology (CST), Phuentsholing, Bhutan

The unprecedented experience of national lockdowns and uncertainty of academic career due to the COVID-19 pandemic has multifaceted impacts on mental health among university students worldwide. This study determined its impact on depression and anxiety level, and associated risk factors among engineering students studying at College of Science and Technology (CST), Phuentsholing, Bhutan during the first lockdown in the country. Self-reported depression and anxiety levels were assessed using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) respectively. Data was collected using an e-questionnaire link generated in Google form and the link was shared with students via the student's official email group. A total of 278 students (response rate, 26.9%) completed the questionnaire. The majority of respondents were male (69.8%) and were aged from 18 to 30 (Mean: 21.7 ±SD 2.07) years. The prevalence of self-reported moderate to severe depression and anxiety were 44.2% (95% CI, 38.5-49.6) and 27.3% (95% CI, 22.3-32.4) respectively. Participants having their family members as frontline workers reported a significantly higher level of anxiety (χ2 = 4.85, p = 0.028). In multivariable logistic regression analysis, students who were academically lagging showed a higher risk of depression (AOR = 5.36, 95% CI = 2.86-10.04) and anxiety (AOR = 3.83, 95%CI = 1.86-7.88) as compared to students who were not academically behind. A high percentage of depression and anxiety was reported by students of CST during the COVID-19 pandemic. Findings from the study highlight the importance of adopting appropriate online-based teaching and learning methods to ensure timely academic and professional achievements. Moreover, the relevant stakeholders should put health system strategies in place to provide psychological support to university students during the COVID-19 pandemic.