Academic Stress in the Final Years of School: A Systematic Literature Review

A U-shaped relationship between chronic academic stress and the dynamics of reward processing

Despite the potential link between stress-induced reward dysfunctions and the development of mental problems, limited human research has investigated the specific impacts of chronic stress on the dynamics of reward processing. Here we aimed to investigate the relationship between chronic academic stress and the dynamics of reward processing (i.e., reward anticipation and reward consumption) using event-related potential (ERP) technology. Ninety healthy undergraduates who were preparing for the National Postgraduate Entrance Examination (NPEE) participated in the study and completed a two-door reward task, their chronic stress levels were assessed via the Perceived Stress Scale (PSS). The results showed that a lower magnitude of reward elicited more negative amplitudes of cue-N2 during the anticipatory phase, and reward omission elicited more negative amplitudes of FRN compared to reward delivery especially in high reward conditions during the consummatory phase. More importantly, the PSS score exhibited a U-shaped relationship with cue-N2 amplitudes regardless of reward magnitude during the anticipatory phase; and FRN amplitudes toward reward omission in high reward condition during the consummatory phase. These findings suggest that individuals exposed to either low or high levels of chronic stress, as opposed to moderate stress levels, exhibited a heightened reward anticipation, and an augmented violation of expectations or affective response when faced with relatively more negative outcomes.

Asian Rainbow Youth in New Zealand: Protective Factors

PURPOSE

To explore the impacts of double minority status (ethnic and sexual/gender minority) and protective factors associated with the emotional wellbeing and mental health of Asian Rainbow (sexual/gender minority) youth in New Zealand.

METHODS

The data were extracted from the Youth19 Rangatahi survey, which surveyed 7,374 students from 45 mainstream secondary schools. The comparison groups were Asian non-Rainbow youth and Pākehā (New Zealand European) Rainbow youth. A secondary analysis was performed examining the associations between postulated protective factors and the emotional wellbeing and mental health outcomes of Asian Rainbow youth.

RESULTS

Asian Rainbow youth had higher odds of depressive symptoms, anxiety, and suicidal thoughts and attempts and lower odds of good emotional wellbeing compared to Asian non-Rainbow youth. However, Asian Rainbow youth had lower odds of anxiety compared to Pākehā Rainbow youth. Among Asian Rainbow youth, family acceptance and feeling safe at school were associated with higher odds of good emotional wellbeing, and lower odds of depressive symptoms, anxiety, and suicidal thoughts. Several other protective factors were also associated with 1 or more (but not all) of the emotional wellbeing and mental health indicators.

DISCUSSION

This study suggests that family acceptance and feeling safe at school may serve as important buffers mitigating risks of adverse emotional wellbeing experienced by Asian Rainbow youth.

Longitudinal Associations Between Depression, Suicidal Ideation, and Lack of Certainty in Control among Adolescents: Disaggregation of Within-Person and Between-Person Effects

PURPOSE

Depression and suicidal ideation (SI) are common in adolescents. However, the relation between the two is unclear. According to the cognitive model of suicidal behavior and learned helplessness theory, lack of certainty in control (LCC), referring to individuals' deficiency in predictability, certainty, and control of life, may be an important factor linking the two. Thus, the current study aimed to investigate the temporal relation between depression and SI in adolescents and to assess the mediating role of LCC in this relation.

METHODS

A three-wave survey was carried out at intervals of 1 and 1.5 years among 516 adolescents at several middle schools in Sichuan Province, China. The random-intercept cross-lagged panel model was used to examine the temporal relations between depression, SI, and LCC among adolescents, which can effectively distinguish between-person and within-person differences.

RESULTS

The results revealed that depression, SI, and LCC had positive intercorrelations at the between-person level. At the within-person level, early depression predicted subsequent depression and SI via LCC among adolescents. Additionally, early LCC promoted later SI through depression.

DISCUSSION

These findings highlight the mediating role of LCC, clarify the temporal relation between depression and SI, and provide theoretical support for interventions to address depression and suicide.

Academic Stress Interventions in High Schools: A Systematic Literature Review

The experience of academic stress is common during high school and can have significant negative consequences for students' educational achievement and wellbeing. High school students frequently report heightened levels of school-related distress, particularly as they approach high-stakes assessments. Programs designed to reduce or prevent academic stress are needed, and their delivery in school settings is ideal to improve treatment access. The current review aimed to examine the effectiveness of high school-based programs in reducing or preventing academic stress. A systematic search returned 31 eligible studies across 13 countries. Programs were categorised according to intervention type, format, and facilitator. Results showed that the methodological quality of most studies was poor, and many used an inactive control group. As predicted by theories of academic stress, the strongest evidence was for programs grounded in cognitive-behavioural therapy (CBT). There was evidence that both universal and targeted approaches can be beneficial. The unique implementation issues for these two formats are discussed. Most programs were delivered by psychologists and were generally effective, but almost all of these were CBT programs. A smaller proportion of programs delivered by teachers were effective. Therefore, future studies should evaluate the implementation success of programs to improve the rate of effective delivery by school staff. Overall, the field will benefit from more randomised controlled trials with comparisons to active control groups, larger sample sizes and longer-term follow-ups.

Perfectionism as a predictor of change in digital self-guided interventions for public speaking anxiety in adolescents: A secondary analysis of a four-armed randomized controlled trial

Public Speaking Anxiety (PSA) interventions targeting adolescents exist; however, not all gain improvement. This exploratory study investigated whether PSA interventions resulted in a decrease in perfectionism and whether pre-treatment level and changes in perfectionism moderated the effects on PSA and social anxiety. The sample consisted of 100 adolescents from junior high schools randomized to four groups: 1) VR only (n = 20), 2) VR + online exposure program (n = 20), 3) online psychoeducation and online exposure program (n = 40), 4) waitlist and online psychoeducation program (n = 20). Self-reported symptoms of PSA, social anxiety, and perfectionism were measured at pre, week 3, post, and 3-months follow-up. Level and change in outcome variables were analyzed using latent growth curve modeling. Results revealed that the interventions did not lead to a reduction in perfectionism. Reduction in perfectionism was associated with a larger reduction in all outcome measures from post to follow-up. No interaction was found between pre-treatment perfectionism and PSA symptoms. High pre-treatment levels of perfectionism were associated with poorer outcomes on social anxiety symptoms from post to follow-up for online exposure groups. The results indicate that one should assess and address high pre-treatment levels of perfectionism during PSA interventions.

Identifying overcontrol and undercontrol personality types among young people using the five factor model, and the relationship with disordered eating behaviour, anxiety and depression

BACKGROUND

Overcontrol and undercontrol personality types have been associated with an increase in eating pathology, depression and anxiety. The aim of the research was to explore whether latent overcontrol and undercontrol personality types could be identified using cluster analysis of the facets of the five factor model (FFM). We further aimed to understand how these personality types were associated with eating pathology, depressed mood and anxiety.

METHODS

A total of 561 participants (394 women and 167 men), aged 16-30 years in Australia completed a survey designed to assess disordered eating, FFM personality traits, anxiety, depression and stress. A systematic four-step process using hierarchical, k-means, and random forest cluster analyses were used to identify a meaningful 3-cluster solution.

RESULTS

The results revealed a cluster solution that represented overcontrol, undercontrol and resilient personality types, and highlighted facets of the FFM that were associated with each type. Both overcontrol and undercontrol personality types were associated with increased clinical symptoms compared to the resilient types.

CONCLUSIONS

It was concluded that FFM facets may potentially be more meaningful than broad domains in identifying personality types, and that both overcontrol and undercontrol personality types are likely associated with increased clinical symptoms.

Mediating effects of sleep on mental health in older adolescents: Findings from the Burn 2 Learn randomized controlled trial

PURPOSE

Our study explored the mediating effect of sleep-related variables on older adolescents' mental health in the context of a school-based physical activity intervention.

METHODS

We evaluated the Burn 2 Learn (B2L) intervention using a cluster randomized controlled trial, which included two cohorts. Participants for this sub-study were from the second cohort, which included 292 older adolescents (16.0 ± 0.5 years) from 10 secondary schools in New South Wales, Australia. Teachers at intervention schools delivered two high-intensity activity breaks (approximately 10 mins) per week to students during academic lessons. Participants completed measures of mental health (i.e., perceived stress and internalizing problems) and hypothesized mediators (i.e., sleep duration, sleep latency, awakenings, and daytime sleepiness) at baseline (February-April 2019) and post-intervention (August-September 2019). Single mediation analyses were conducted to explore the potential mediating effects of sleep variables on mental health outcomes using a product-of-coefficient test.

RESULTS

We observed a small statistically significant effect for perceived stress (β = -0.11, SE = 0.034, p = 0.002), but not for internalizing problems (β = 0.02, SE = 0.051, p = 0.760). There were no significant intervention effects for sleep-related variables. Several sleep-related variables were associated with mental health outcomes but no mediated effects were found.

CONCLUSION

The B2L intervention had a small beneficial effect on perceived stress, however our mediation analyses suggest this was not explained by changes in sleep-related variables. Markers of sleep were associated with mental health constructs, highlighting the importance of sleep for good psychological health. However, in the context of a physical activity intervention, effects on mental health may be driven by other behavioral, neurobiological, or psychosocial mechanisms.

The association between academic pressure and adolescent mental health problems: A systematic review

BACKGROUND

Academic pressure is a potential contributor to adolescent mental health problems, but international evidence on this association has never been synthesised.

METHODS

We conducted the first systematic review of the association between academic pressure and adolescent depression, anxiety, self-harm, suicidality, suicide attempts and suicide. We searched MEDLINE, PsycINFO, ERIC and Web of Science (core collection) up to November 24, 2022, for studies of school-going children or adolescents, which measured academic pressure or timing within the school year as the exposure and depression, anxiety, self-harm, or suicidal ideation, attempts or suicide as outcomes. Risk of bias was assessed using the Mixed Methods Appraisal Tool. We used narrative synthesis to summarise the evidence. The review was prospectively registered with PROSPERO (CRD42021232702).

RESULTS

We included 52 studies. Most studies assessed mixed anxiety and depressive symptoms (n = 20) or depressive symptoms (n = 19). Forty-eight studies found evidence of a positive association between academic pressure or timing within the school year and at least one mental health outcome.

LIMITATIONS

Most studies were cross-sectional (n = 39), adjusted for a narrow range of confounders or had other limitations which limited the strength of causal inferences.

CONCLUSIONS

We found evidence that academic pressure is a potential candidate for public health interventions which could prevent adolescent mental health problems. Large population-based cohort studies are needed to investigate whether academic pressure is a causal risk factor that should be targeted in school- and policy-based interventions.

FUNDING

UCL Health of the Public; Wellcome Institutional Strategic Support Fund.

Editorial Perspective: What can we learn from hunter-gatherers about children's mental health? An evolutionary perspective

Humans lived as hunter-gatherers for more than 95% of our evolutionary history, thus studying contemporary hunter-gatherer populations offers insight into the conditions children may be psychologically adapted to. Here, we contrast hunter-gatherer childhoods with those of WEIRD (Western Educated Industrialised Rich Democratic) societies and consider the implications for children's mental health. Hunter-gatherer infants receive continuous physical contact and more sensitive and responsive caregiving than is typical of WEIRD societies, due to the extensive involvement of alloparents (non-parental caregivers) who generally provide 40-50% of their care. Alongside positive attachment outcomes, alloparenting likely reduces the harms of family adversity and risk of abuse/neglect. From late infancy, hunter-gatherers spend their time in mixed-age 'playgroups' where they learn via active play and exploration without adult supervision. This contrasts with WEIRD norms surrounding the need for adult supervision of children, as well as with the passive teacher-led classrooms, which could potentially lead to suboptimal learning outcomes and pose difficulties to children with ADHD. Based on this preliminary comparison, we consider practical solutions to potential harms arising from discordance between what children are adapted to and exposed to. These include infant massage and babywearing; increased sibling and extra-familial involvement in childcare; and educational adjustments.

The associations between academic stress and depression among college students: A moderated chain mediation model of negative affect, sleep quality, and social support

BACKGROUND

Growing competition in tight job market and academic excellence as a social norm in Asian culture have made Chinese college students burdened with immense academic stress.

OBJECTIVES

This study aimed to explore the associations between academic stress and depression, and the mediating roles of negative affect and sleep quality, as well as the moderating role of social support in the relationship between negative affect and sleep quality.

METHODOLOGY

A convenience sample of 221 male and 479 female college students aged between 17 and 25 completed questionnaires on academic stress, depression, negative affect, sleep quality and social support.

RESULTS

Results indicated that academic stress could not only directly affect depression (b = 0.31, p < 001), but also affect depression through the mediation role of negative affect and sleep quality. The chain mediating effects includes three paths, namely, the mediating role of negative affect (indirect effect = 0.21, percentage of total effect = 69.58 %), the mediating role of sleep quality (indirect effect = 0.06, percentage of total effect = 21.03 %), and the chain mediating role of negative affect and sleep quality (indirect effect = 0.06, percentage of total effect = 19.86 %). Social support moderated the adverse influence of negative affect on sleep quality. Social support decreases the impact of negative affect on sleep quality. Specifically, the association between negative affect and sleep quality was stronger for college students with low (bsimple = 0.44, p < 0.001) social support than those with high (bsimple = 0.32, p < 0.001) social support.

IMPLICATIONS

The results advanced our understanding of how academic stress affects college students' depression. These findings provide implications on the cultivation of stress coping strategies, promotion of emotion regulation skills, exaltation of sleep quality, and improvement of the social support level aiming for future depression preventions and interventions. Specific measures include setting up psychological health courses, teaching emotion management strategies, and establishing web-based programme steming from acceptance and commitment therapy. It should be noted that the cross-sectional design means the causal associations among the variables could not be determined.

Stress of school performance among secondary students: The role of classroom goal structures and teacher support

With concern growing about the increasing levels of school stress among secondary school students, examining its associations with students' perceptions of important elements in classroom climate can offer valuable scientific information. However, there is minimal research about the role of perceived classroom goal structures and teacher support in school stress. In addition, most research on classroom goal structure has not made a distinction between performance-approach structures and performance-avoidance structures, which may have different effects on school stress. The aim of the present study was to examine the role of classroom goal structures and teacher support in students' stress linked to school performance. We also examined the potential moderating effect of teacher support in the association between classroom goal structures and stress. Our sample consisted of 4768 secondary school students aged 11-17 years (M_age = 13.74; 47.9% boys) from 54 schools in Andalusia, Spain. Consistent with the study's aims, hierarchical multilevel multiple regression was used to examine the relationships between mastery goal structure, performance-approach goal structure, performance-avoidance goal structure, and teacher support on our stress of school performance outcome. After controlling for gender, age, and previous academic achievement, performance-avoidance goal structure was significantly associated with higher levels of stress of school performance (p < .01). Furthermore, perceived classroom goals and teacher support tended to work together, with the role of performance-approach goal structure being dependent on the levels of mastery goal structure and teacher support (p < .05). Practical implications from these findings and future research directions are discussed.

The Perception of Volleyball Student-Athletes: Evaluation of Well-Being, Sport Workload, Players' Response, and Academic Demands

Physical activity has been shown to improve the health and well-being of students, athletes and the general population, especially when it is properly monitored and responses are evaluated. However, data are mostly gathered without considering a valuable element, participants' perceptions. Therefore, the objective was to know the perception of volleyball student-athletes when using different monitoring and response tools that assess well-being, workloads, responses to workloads, and academic demands. A qualitative study using semi-structured interviews with female volleyball student-athletes (n = 22) was used to know players' perceptions when using a wellness/well-being questionnaire, session ratings of perceived exertion (sRPE), and countermovement jumps (CMJ), and consider academic demands. Results show that the wellness questionnaire and sRPE increased student-athletes' awareness of well-being and readiness to perform, improved self-evaluation, self-regulation, and self-demand. However, motivation and overcoming challenges were based on the CMJ. Academic demands affected 82% of student-athletes, altering stress, fatigue, and sleep quality. Nonetheless, sport was seen as an activity that helped with academic commitments. Therefore, the wellness questionnaires and the sRPE facilitated self-awareness and positive dispositions toward self-regulation. Simultaneous intensive academic demands and training can produce mutual positive effects if the variables of physical and mental loads are harmonized in the critical academic and sports periods.

Health-Related Quality of Life in Childhood and Adolescence: The Interrelation with Level of Adherence to Mediterranean Diet and Dietary Trajectories: Highlights from the DIATROFI Program (2021-2022)

Children's dietary habits can have a key role in contributing to an improvement in their Health-Related Quality of Life (HRQoL). This study aims to assess the connection between Mediterranean diet adherence and HRQoL in a sample of Greek students, utilizing data from the DIATROFI program. The parents of 3774 students (mean age 7.8 (2.6) years) reported their children's HRQoL and level of adherence to the Mediterranean dietary pattern at the beginning and end of the 2021-2022 school year. At baseline, most students' adherence was characterized as moderate (55.2%) or high (25.1%). Students with moderate or high adherence tο the Mediterranean diet were less likely to report a total HRQoL below the median at baseline (OR = 0.56, 95%CI = 0.44, 0.70), along with all its dimensions (physical, emotional, social, and school functions). A one-unit improvement in KIDMED score _{(beginning-end of schoolyear)} was associated with the likelihood of an improvement in total HRQoL _{(beginning-end of schoolyear)} (OR = 1.09, 95%CI = 1.02, 1.17), emotional (OR = 1.09, 95%CI = 1.02, 1.17), and social functions (OR = 1.13, 95%CI = 1.05, 1.22), but not with physical and school functions. The health benefits of the Mediterranean diet in children may not be limited to disease prevention but also extend to their overall wellbeing.

Academic Stress and Emotional Adjustment: A Gender-Based Post-COVID Study

Background

The worldwide spread of COVID-19 infection and its preventive measures has resulted in global disruption of overall functioning of the individuals. In the post-COVID period, several stressors associated with the pandemic have exacerbated adjustment problems in students and impacted their mental health.

Purpose

The study aims to assess the Academic Stress and Emotional Adjustment of male and female secondary school students in Uttar Pradesh, post-COVID-19 pandemic lockdown.

Methods

A sample of 500 students from various schools in Uttar Pradesh pursuing high school were included in the study. A purposive sampling technique was employed for data collection based on inclusion and exclusion criteria. The Scale for Assessing Academic Stress and the Adolescents Emotional Adjustment Inventory were used to assess the academic stress and emotional adjustment of secondary school students post-COVID-19 pandemic lockdown.

Results

The results of the study revealed that there was a significant difference in academic stress and emotional adjustment between male and female secondary school students. A significant positive relationship between academic stress and emotional adjustment was found, which indicates a high level of academic stress perpetuates emotional maladjustment. Furthermore, it was found that the level of academic stress and emotional adjustment were higher among females as compared to males.

Conclusion

It can be concluded that the extended impact of COVID-19 has led to a surfeited level of distress propounding that females are more predisposed to academic stress and tend to have poor emotional adjustment than their male counterparts.

Developing the HERO within: Evaluation of a brief intervention for increasing Psychological Capital (PsyCap) in Australian female students during the final year of school in the first year of COVID-19

Academic stress is linked to adolescent distress and perfectionism during the final years at school, with girls being at greater risk. The onset of the COVID-19 pandemic was an additional stressor that impacted student learning on a global scale. The present study examines the effectiveness of an intervention targeting Psychological Capital (PsyCap), comprising hope, efficacy, resilience, and optimism (HERO) to increase these HERO resources and assess its impact on mental health symptoms and subjective wellbeing outcomes among a cohort of Year 12 students (n = 82, Mage = 17.09, SD = 0.28, 99% identifying as female) from a girls school during the first year of the pandemic. Primary outcomes of anxiety symptoms, depressive symptoms, and flourishing and secondary outcomes of HERO variables and perfectionism were examined. There were no significant changes in primary outcomes. Significant changes in efficacy, optimism, omnibus PsyCap (HERO combined) and perfectionism were found at post-intervention. Findings indicate the intervention targeting HERO constructs may be promising for developing HERO capabilities in youth and reducing common areas of concern for students (e.g., perfectionism). Future research directions addressing limitations are discussed.

The association between academic stress and test anxiety in college students: The mediating role of regulatory emotional self-efficacy and the moderating role of parental expectations

Academic stress has been showed to be an important factor associated with test anxiety. However, the internal mechanism between them is still not clear. The purpose of this study was to explore whether the relationship between academic stress and test anxiety was affected by parental expectations and regulatory emotional self-efficacy. This study recruited 1,315 volunteers aged 17-25 to complete self-reports on academic stress, parental expectations, regulatory emotional self-efficacy and test anxiety. The results showed that there was a significant positive correlation between academic stress and test anxiety. Additionally, parental expectations were negatively correlated with academic stress but positively correlated with regulatory emotional self-efficacy, and regulatory emotional self-efficacy was negatively correlated with academic stress and test anxiety. The results showed that regulatory emotional self-efficacy played a mediating role in academic stress and test anxiety, and the relationship between academic stress and regulatory emotional self-efficacy was moderated by parental expectations, which indicated that parental expectations and regulatory emotional self-efficacy may play an important role in the relationship between academic stress and test anxiety.

Academic Stress and Sleep Quality among Chinese Adolescents: Chain Mediating Effects of Anxiety and School Burnout

Previous studies have investigated the associations between academic stress and adolescents' psycho-social development. However, the direct and indirect affecting mechanism of academic stress on sleep quality among Chinese adolescents have rarely been investigated. Using a self-report questionnaire data of 1232 adolescents in Jiangsu province, the purpose of the study is to investigate the relationships among academic stress, anxiety, school burnout, and sleep quality. Structural equation modeling (SEM) with Amos 25.0 was used to test the model fit in the present study. The results revealed that academic stress tends to have significantly direct effects on adolescents' sleep quality. Moreover, anxiety and school burnout could mediate the associations between academic stress and sleep quality absolutely and sequentially. This study reveals the mechanism of the effect of academic stress on adolescents' sleep quality and also develops the chain mediating model of anxiety and school burnout. In addition, the present study may shed light on social policy and social work intervention toward adolescents' sleep quality.

Prediction of exam scores using a multi-sensor approach for wearable exam stress dataset with uniform preprocessing

BACKGROUND

Physiological signals, such as skin conductance, heart rate, and temperature, provide valuable insight into the physiological responses of students to stress during examination sessions.

OBJECTIVE

The primary objective of this research is to explore the effectiveness of physiological signals in predicting grades and to assess the impact of different models and feature selection techniques on predictive performance.

METHODS

We extracted a comprehensive feature vector comprising 301 distinct features from seven signals and implemented a uniform preprocessing technique for all signals. In addition, we analyzed different algorithmic selection features to design relevant features for robust and accurate predictions.

RESULTS

The study reveals promising results, with the highest scores achieved using 100 and 150 features. The corresponding values for accuracy, AUROC, and F1-Score are 0.9, 0.89, and 0.87, respectively, indicating the potential of physiological signals for accurate grade prediction.

CONCLUSION

The findings of this study suggest practical applications in the field of education, where the use of physiological signals can help students cope with exam stress and improve their academic performance. The importance of feature selection and the use of appropriate models highlight the importance of engineering relevant features for precise and reliable predictions.

Did Stress Prevalence Among Adolescents in Scandinavia Change from 2000 to 2019? A literature review

Background

Prolonged stress is a risk factor for developing mental illness and stress-related diseases. As there has been an increase in self-reported psychological symptoms and diagnosis of mental illness among Scandinavian adolescents, more knowledge of stress prevalence in this age group is needed.

Aim

This literature review will investigate a possible increase in stress prevalence among Scandinavian adolescents, aged 13-18, between the years 2000 and 2019.

Methods

A systematic literature search was conducted in the PubMed and PsycInfo databases. In addition, a grey literature search was conducted to find relevant surveys and reports. Altogether, nine papers and nine surveys, and reports containing relevant data were identified, assessed for risk of bias, and included in the analysis.

Results

The results show higher stress scores among the older participants in the age group 13-18 years and a gender difference, where girls score higher than boys. The literature neither supports nor rejects the hypothesis that stress levels have increased among adolescents in Scandinavia, from year 2000 to 2019. Only two of the included studies used a validated stress questionnaire and there was a substantial risk of non-response bias. Therefore, the existing literature is considered insufficient to determine if there has been an increase in stress over time. A majority of the papers, surveys, and reports had moderate risk of bias.

Conclusions

Further research using validated stress questionnaires in representative populations is needed to investigate changes in stress prevalence among Scandinavian adolescents. Also, the age and gender difference in stress prevalence among 13-18-year-olds may be of relevance for planning preventive interventions to reduce stress.

Relationship Between Socio-Demographics, Study Skills and Distress Among Pakistani School Students: A Cross-Sectional Study in Riyadh, Saudi Arabia

Purpose

The increasing prevalence of distress among students is of global concern. Several factors such as school and family environment and ineffective study skills could influence mental health. The study explored the rate of distress symptoms among school students' and its relationship with their study skills, stressors and demographic factors.

Methods

In this cross-sectional analytical study, a sample of 215 students from a community school participated in the study. Three questionnaires, demographic questionnaire, Study Skills Inventory and the Kessler Psychological Distress Scale, were used for data collection. Data were analyzed using Student's t-test, ANOVA, Pearson's correlation coefficient and stepwise linear regression.

Results

Response rate was 70% (n = 150). A high proportion of respondents (75%) was distressed (mean 27.28  ±  8.77). Correlation analysis showed that distress (K10 score) was negatively related to study skills (SSI total score) (r = -0.247, p = 0.002). The rate of distress symptoms was higher among female students (79%) compared to their male counterparts (72%). The factors associated with distress included negative association of teachers' level of help to develop competencies (p = 0.000, β = -0.278, R² = 0.249), unfavorable school environment (p = 0.000, β = 0.285, R² = 0.123), inability to cope with studies (p = 0.005, β = 0.205, R² = 0.038), family problems (p = 0.014, β = 0.184, R² = 0.173) and lower study skills (p = 0.031, β = -0.164, R² = 0.270). The overall regression analysis explained 33.6% of the variance (corrected R² = 0.336).

Conclusion

Higher than expected levels of distress (75%) was found in immigrant school students. Poor study skills have a significant relationship with distress. Learning environment and related stress factors were associated with distress among students. Based on the findings, it is recommended that stakeholders in education address the hidden curriculum, as it is usually unacknowledged and might affect students' wellbeing, and move from student centered to an interpersonal relation-centered education.

Invarianza factorial de dos versiones breves de la Escala de Resiliencia de Connor–Davidson (cd-risc) en estudiantes universitarios de Arequipa

La resiliencia es una característica individual que posibilita el reajuste biopsicosocial y espiritual que ayuda al bienestar psicológico y al desenvolvimiento académico de los estudiantes universitarios. El objetivo de esta investigación fue analizar la invarianza de medición según el sexo, de dos versiones breves de la Escala de Resiliencia de Connor–Davidson (cd-risc) y determinar si existen diferencias entre hombres y mujeres. Se evaluó con la cd-risc-10, que incluye la cd-risc-7, a una muestra de 491 universitarios arequipeños (312 mujeres; 179 hombres) con edad promedio de 20.56 años (de = 3.18),de una institución privada. Inicialmente se realizó un análisis factorial multigrupo con cada versión para valorar el grado de invarianza de medición alcanzado, y luego de ello se compararon las medias latentes de resiliencia entre hombres y mujeres. En cuanto a los resultados, la cd-risc-7 presentó indicadores estructurales más favorables (e.g., λ > .50; en mujeres:cfi = .981, rmsea = .087, wrmr = 0.683; en hombres: cfi = .966, rmsea = .124, wrmr = 0.783), que la cd-risc-10(e.g., λ < .50, índices de ajuste en mujeres: cfi = .974, rmsea = .073, wrmr = 0.774; en hombres: cfi = .960, rmsea = .095, wrmr = 0.803) incluyendo la invarianza de medición (invarianza estricta: Δcfi = .003; δrmsea = .001), y al comparar las medias latentes fueron halladas diferencias significativas a favor de los hombres (d = .471). Finalmente, se discuten las implicancias teóricas y metodológicas de los hallazgos, así como la necesidad de ampliar los estudios considerando otros aspectos relevantes para una mejor comprensión del constructo resiliencia.

The Impact of School Education on Depressive Symptoms in Chinese Adolescents: a Prospective Longitudinal Study

There is a growing but limited literature on psychological distress among Chinese students, especially the impact of the COVID-19 pandemic, using a longitudinal comparison between in school and at home. This study aimed to assess the psychological status of adolescents in school and related risk and protective factors. We surveyed 13,637 adolescents before the COVID-19 outbreak (T1) and 10,216 after two months of home confinement (T2). The 9-item Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms or the severity of depression among the adolescents. In addition, the Childhood Trauma Questionnaire and the Connor-Davidson Resilience Scales were also used to screen for experiences of abuse and neglect and to measure resilience in adolescents. At baseline, 22.34% reported depressive symptoms. At T2, this rate decreased to 14.86%. When adolescents were in school, age (P < .0001), gender (P < .0001), and experience of abuse (P < .0001) were risk factors, while parent-child relationship (P < .0001), and resilience (P < .0001) were protective factors for depressive symptoms. After leaving school, age and physical abuse were no longer risk factors for depression. The negative impact of school education on the mental health of adolescents in China exceeds even the impact of the pandemic and home isolation. The focus should be on those adolescents with abuse experience and poor parent-child relationships to prevent the onset of psychological and psychiatric disorders.

Symptoms of Anxiety and Depression Among Adolescents Before vs During COVID-19-Related School Closures in China

This cohort study compares the psychological status of Chinese adolescents at school before the COVID-19 pandemic and at home during the pandemic to assess whether school attendance was associated with negative mental health outcomes.

Effect of low frequency sound vibration on acute stress response in university students-Pilot randomized controlled trial

Background

Low frequency sound (LFS, combined with music listening) is applied by practitioners in vibroacoustic therapy who report a positive effect of this intervention on acute stress response. However, there is a lack of research on this topic and studies with mainly objective measurements are scarce.

Materials and methods

In this pilot double-blinded Randomized Controlled Trial we used a multimodal approach to measurement of acute stress response in 54 international university students attending a university summer school in Olomouc, the Czech Republic who were individually randomized into a group receiving LFS vibration and a control group. In both groups, the acute stress response was measured by heart rate variability (HRV), visual analogue scales (VAS) for stress and muscle relaxation.

Results

Differences were found in pre-test post-test measures, however, between groups differences occurred only for HRV, with statistically significant improvement in the experimental group (parameter LF/HF and pNN50).

Conclusion

Vibroacoustic therapy has the potential to contribute to the stress management of university students. Further research is needed to explore the effect of LFS on stress response, especially when applied without additional music listening.

Prestatiedruk en schoolstress bekeken vanuit verschillende perspectieven

Jongeren ervaren de laatste jaren steeds meer schoolstress en druk door school. Om goed inzicht te krijgen in de factoren die ten grondslag liggen aan deze toename en mogelijk een schakel zijn voor verandering, is het van belang om dit maatschappelijke probleem vanuit verschillende perspectieven te bekijken. In dit onderzoek verbinden we wetenschappelijke kennis (systematisch literatuuronderzoek) met praktijk- en ervaringskennis van professionals, beleidsmedewerkers, ouders en jongeren (diepte-interviews, n = 60). De resultaten van dit onderzoek laten zien dat de beschermende factoren op verschillende niveaus (systeem, directe omgeving, individu) met elkaar interacteren. De maatschappij legt veel nadruk op resultaat en prestaties, wat invloed heeft op de verwachtingen van jongeren en ouders, en de inrichting van ons onderwijssysteem. Scholen kunnen jongeren ondersteunen bij hun ontwikkeling door aandacht te besteden aan bredere talentontwikkeling, alternatieve beoordelingsvormen, goed mentorschap en de sociaal-emotionele ontwikkeling. Om de ervaren schoolstress en druk door school te verminderen is het belangrijk om niet alleen het individu weerbaarder te maken, maar ook de directe omgeving en de school/maatschappij mee te nemen in preventieve maatregelen om schoolstress en ervaren druk te minderen.

Depressive Symptoms Among Children and Adolescents in China During the Coronavirus Disease-19 Epidemic: A Systematic Review and Meta-Analysis

Background

The Coronavirus Disease-19 (COVID-19) pandemic negatively impacts mental health. Some published studies have investigated the prevalence of depression among children and adolescents in China during the pandemic. However, the results vary widely. We aimed to systematically analyze and estimate the prevalence of depressive symptoms and attempted to reveal the reasons for prevalence variety in previous studies.

Methods

Published studies were searched in PubMed, Embase, Cochrane Central, the Chinese Scientific Journal Database (VIP Database), China National Knowledge database (CNKI), and the WanFang database from December 2019 to May 2021. The quality of all included studies was assessed by the Joanna Briggs Institute (JBI) checklist and the American Agency for Health Care Quality and Research's (AHRQ) cross-sectional study quality evaluation items. Meta-analysis was performed using random-effects modeling.

Results

Of the 1,708 references screened, 13 related reports that involve 41,729 participants were included. The results suggested that the pooled prevalence of depressive symptoms among Chinese children and adolescents during the COVID-19 epidemic was 28.6%. Subgroup analyses showed that the pooled prevalence was highest among the studies using the Patient Health Questionnaire (PHQ)-9 (46.8%) and lowest among these using Depression Self-Rating Scale for Children (DSRSC) (11.4%). All studies using PHQ-9 set the cutoff at 5 points instead of 10. The pooled prevalence of studies that include primary school students was lower (16.5%) than that of studies excluding primary school students (39.1%).

Conclusion

The meta-analysis suggests that depressive symptoms were relatively prevalent among Chinese children and adolescents during COVID-19, especially among the secondary school students. The suitable screening tools and cutoff should be carefully chosen in the survey.

School-Related Stressors and the Intensity of Perceived Stress Experienced by Adolescents in Poland

Higher stress reactivity during adolescence is a vulnerability marker of exposure to various environmental stressors. This study aimed to investigate the association between a high level of perceived stress experienced by adolescents and stressful stimuli induced from school environment, peer, and parental relationships. The data used were from a cross-sectional, observational study conducted in a stratified sample of 1846 adolescents (13-18 years) in the Wielkopolska province, Poland. Data were collected through self-administered questionnaires and anthropometric measurements. Perceived stress was assessed using the Perceived Stress Scale (PSS-10). The association of a high level of perceived stress with school-induced exposures was determined using multivariate logistic regression after adjusting for gender, age, height and weight status and interpersonal relationships (STATISTICA 13.1). It was found that girls were over three times more likely than boys to experience a high level of perceived stress. Moreover, girls appeared to be more vulnerable than boys to school-related stressors and weight status, while boys to stressors that can arise from interpersonal relationships. School environment was the only predictor factor of high perceived stress level with a large effect size in both boys (OR = 4.45; 95% CI: 3.11-6.36) and girls (OR = 6.22; 95% CI: 4.18-7.59). Given the findings of the present study, preventive programs are critical to mitigate the effect of stress from school on adolescents' health and well-being.

Teachers use of fear appeals: Association with student and teacher mental health

BACKGROUND

Fear appeals are discourses commonly used by teachers to motivate students especially when academic outcomes are paramount. Fear appeals have been associated with better and worse academic performance by the student recipients, with some evidence that fear appeals are detrimental for students who are anxious and have lower self-efficacy. Little is known about the factors that drive teachers' use of fear appeals beyond a desire to increase motivation to excel.

AIMS

This study examined the relationship between the use of fear appeals, psychological distress, and self-efficacy in both teachers and students.

SAMPLE

Participants were 377 students (81% female, age range 15 to 18, M = 16.68, SD = 0.49) and 96 teachers (73% female, Mean years teaching = 18.04, SD = 12.39).

METHODS

Participants completed surveys mid-way through the first school term of their final year of high school. Student surveys examined student anxiety, depression, stress, self-efficacy, and experience of teacher fear appeals. Teacher surveys examined teacher anxiety, depression, stress, emotional burnout, self-efficacy, years of teaching, and use of fear appeals.

RESULTS

Teachers use of fear appeals was associated with student distress which was heightened for students with lower academic self-efficacy. Similarly, teachers' use of fear appeals was associated with higher anxiety and lower self-efficacy in teachers themselves.

CONCLUSIONS

Therefore, the use and consequence of fear appeals is strongly linked to both student and teacher self-efficacy and distress. Given the detrimental impacts of fear appeals on academic performance in vulnerable students, more research is needed on the consequences of fear appeals.

Tracking stress, depression, and anxiety across the final year of secondary school: A longitudinal study

Levels of distress, which include stress, depression, and anxiety, are often heightened during the final year of secondary school and have been linked to major examinations that occur during this time period. However, relatively little is known about how these symptoms change over the course of the year or what moderates symptom severity. Using a longitudinal survey design, we tracked student outcomes and potential moderators (i.e., gender, test anxiety, self-efficacy, connectedness with peers, school and family, perceived use of fear appeals by teachers) associated with stress, depression, and anxiety once per term (i.e., 4 times total) over the final year of high school in seven Australian high schools. We hypothesised that student symptoms would increase over time and that symptom severity would be moderated by individual and environmental factors. Six hundred and thirty-eight unique students (M age = 16.95 years, SD = 0.56, range = 15-18 years, female = 474 [74.29%]) participated in at least one of the four surveys administered during each term of the final year of high school. Linear mixed models indicated that stress (d = 0.2) and anxiety (d = 1.7) increased over time. When all potential moderators of distress were entered into the full model, gender, test anxiety, emotional self-efficacy, and peer connectedness were all significant unique predictors of stress. Similar patterns were found for symptoms of depression and anxiety. Time 3 stress was predicted by unique variance in baseline stress, higher test anxiety, and academic self-efficacy. Overall distress increased over time and was moderated by gender, as well as by test anxiety, self-efficacy, and peer connectedness, which are areas that can then be targeted by interventions designed to maintain distress at optimum levels for wellbeing and academic performance.

Implementation trial of a cognitive behavioural therapy programme for reducing student stress in the final year of secondary school

The final year of secondary school has been shown to be associated with heightened student stress. Psychological interventions have been shown to be effective in reducing and preventing distress in students during this school period, although the widespread adoption of these interventions into school settings is limited. There have been recent calls for research to examine the implementation success of evidence-based programmes when used by schools in school settings. The present study aimed to evaluate the implementation success of an evidence-based cognitive-behavioural therapy programme (Study without Stress) using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. At one Australian high school, all tutor group teachers were trained by the school counsellor to deliver the programme in standard school classes to students in the lead up to their final year of secondary school. Students (n = 80) and teachers (n = 11) reported on programme success against the RE-AIM framework at pre-intervention, post-intervention, and three-month follow-up. The findings indicated that SWOS was implemented successfully by the school. SWOS was associated with maintaining student stress levels at normal levels over time, as well as reducing the severity of stress for initially highly distressed students. The findings provide evidence from implementation science that SWOS can be adapted and delivered effectively by school staff to manage stress in final year secondary school students.

The Impact of Self-Efficacy, Optimism, Resilience and Perceived Stress on Academic Performance and Its Subjective Evaluation: A Cross-Sectional Study

This study aimed to highlight the contribution of self-efficacy, optimism, resilience and perceived stress on academic performance (GPA) at medical undergraduate students. Additionally, we investigated the relationship established between abovementioned variables, gender and position in the academic cycle and the factors associated with satisfaction regarding own academic results. 118 students (25 men, 93 women, mean age 22.863, SD = 1.763) participated in the study. They were administered the General Self-Efficacy Scale (G-SES), the Revised Life Orientation test (LOT-R), the Brief Resilience Scale (BRS) and the Perceived Stress Scale (PSS). t, Wilcoxon-Mann-Whitney, chi-square tests, and linear regressions were performed, in order to test the strength of the hypothesized associations. Data analysis demonstrates a significant association between low optimism, low resilience, high perceived stress and poor academic performance. Even though preclinical students displayed greater perceived stress, it negatively correlated to GPA only in clinical students, this indicating a possible accumulation of stress-related effects. No gender differences were met for the studied variables. Students in clinical cycle were significantly less satisfied about their own performance. These results indicate solid associations between psychosocial variables and academic performance, and differences in the subjective evaluation of own performance, suggesting key points to address, when designing interventions against academic stress.

Physical activity, screen exposure and sleep among students during the pandemic of COVID-19

This study aimed to determine the levels of health-related behaviours (physical activity, screen exposure and sleep status) among Chinese students from primary, secondary and high schools during the pandemic of COVID-19, as well as their changes compared with their status before the pandemic. A cross-sectional online survey of 10,933 students was conducted among 10 schools in Guangzhou, China, between 8th and 15th March, 2020. After getting the informed consent from student's caregivers, an online questionnaire was designed and used to obtain time spending on health-related behaviours during the pandemic of COVID-19, as well as the changes compared with 3 months before the pandemic, which was completed by students themselves or their caregivers. Students were stratified by regions (urban, suburban, exurban), gender (boys and girls), and grades (lower grades of primary school, higher grades of primary schools, secondary schools and high schools). Data were expressed as number and percentages and Chi-square test was used to analyse difference between groups. Overall, the response rate of questionnaire was 95.3% (10,416/10,933). The median age of included students was 13.0 (10.0, 16.0) years and 50.1% (n = 5,219) were boys. 41.4%, 53.6% and 53.7% of total students reported less than 15 min per day in light, moderate and vigorous activities and 58.7% (n = 6,113) reported decreased participation in physical activity compared with the time before pandemic. Over 5 h of screen time spending on online study was reported by 44.6% (n = 4,649) of respondents, particular among high school students (81.0%). 76.9% of students reported increased screen time compared with the time before pandemic. Inadequate sleep was identified among 38.5% of students and the proportion was highest in high school students (56.9%). Our study indicated that, during the COVID-19 pandemic, the school closure exerted tremendous negative effects on school-aged children's health habits, including less physical activity, longer screen exposure and irregular sleeping pattern.

Randomised Controlled Trial of Study Without Stress: A Cognitive Behavioural Therapy Program to Reduce Stress in Students in the Final Year of High School

Typically students in their final year of school report high levels of anxiety, depression and stress. This study evaluated Study without Stress, a group cognitive behavioural program to reduce student stress. Fifty-six final year students (77% female) from four Australian secondary schools were randomly allocated to Study without Stress delivered by school staff, or to an 8-week usual care condition. Changes in self-reported stress, anxiety, depression, self-efficacy, and teacher reported emotional problems were assessed pre to post-treatment using intent-to-treat analyses. Maintenance of changes were examined 3-months later. Compared to usual care, Study without Stress led to significant reductions in self-reported stress and distress, and increases in self-efficacy that were maintained over time, with no significant changes in anxiety, depression or teacher reported emotional problems. Study without Stress is beneficial for reducing academic stress and improving self-efficacy in final year students when delivered in a school setting.