Feasibility of a Brief Online Mindfulness and Compassion-Based Intervention to Promote Mental Health Among University Students During the COVID-19 Pandemic

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

TRIAL REGISTRATION

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

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/23117.

Psychological Interventions and Those With Elements of Positive Psychology for Child and Youth Mental Health During the COVID-19 Pandemic: Literature Review, Lessons Learned, and Areas for Future Knowledge Dissemination

BACKGROUND

There was a marked decline in child and teenage mental health worldwide during the pandemic, with increasing prevalence of depression, anxiety, and suicide. Research indicates that positive psychological interventions may be beneficial for mental health.

OBJECTIVE

The aims of this review were to evaluate positive psychological interventions for child and youth mental health implemented during the COVID-19 pandemic and assess overall effectiveness for mental health and knowledge.

METHODS

We undertook a literature search of PubMed, MEDLINE, and Google Scholar for all eligible studies on digital and hybrid in-person psychological interventions for youth mental health during the COVID-19 pandemic. A particular emphasis was placed on positive psychological interventions or interventions that had components of positive psychology, including gratitude, acceptance, positive emotions, or resilience building.

RESULTS

A total of 41 interventions were included in this review. Most of the interventions were digital. Overall, most of the interventions assisted with one or more mental health or psychological indicators, such as depression, anxiety, posttraumatic stress disorder, stress, and resilience. However, findings were mixed when it came to targeting both depression and anxiety together. The interventions that promoted youth mental health most often had a range of diverse positive psychology components and were evidence based. Not all studies measured changes in mindfulness. Few studies examined knowledge acquired on mental health self-care, managing mental health problems, knowledge of positive psychological techniques, mindfulness knowledge, or mental health self-efficacy.

CONCLUSIONS

Diverse multicomponent interventions appear to assist with youth mental health overall, although their effects on both depression and anxiety are less clear. There is also a need for more research on knowledge gains to determine whether the interventions improved knowledge on mental health-supportive behaviors, which may be sustained beyond the intervention. Finally, more studies need to evaluate whether the interventions assisted with increasing self-efficacy for practicing positive psychological techniques as well as changes in mindfulness levels. Future studies should not only assess effectiveness for mental health outcomes but also assess knowledge translation, with valid measures of knowledge and self-efficacy for mental health-supportive behaviors and positive psychological skills acquired (eg, the ability to practice mindfulness).

Mental health and health behaviors among college student mentors in a randomized controlled trial interrupted by COVID-19

Objective: The benefits of mindfulness-training and mentoring for college students have yet to be investigated. We aimed to provide an exploratory and descriptive account of their potential benefits during the COVID-19 pandemic. Participants: In February 2020, 49 undergraduates (M = 20.51 years-old; 94% female) participated in a randomized trial of 12-week mentoring + mindfulness or mentoring-as-usual. After five weekly mentoring-sessions, programs were interrupted by COVID-19; mentoring continued online. Methods: Undergraduates completed questionnaires about mental health, behaviors, and regulatory processes in February and July 2020, with additional COVID-19-related questions at follow-up. Results: Participants reported moderate COVID-19-related perceived stress, but mental health, health behaviors, and regulatory processes did not diminish over time, with no condition differences. Undergraduates described using contemplative practices and social support to cope with COVID-19-stress. Conclusions: Undergraduates showed stable mental health/health behaviors despite moderate COVID-19-related-stress. Future research on mentoring with a mindfulness component among a larger and more heterogeneous sample will be necessary.

Patient-reported assessment of compassion in Spanish: a systematic review

Aims and objectives

This systematic review aims to: (1) explore which tools have been used in Spanish to measure compassion; (2) know which of these tools could be used to assess compassion in healthcare settings from the perspective of patients; (3) evaluate the quality of these patient-reported measures in Spanish contexts; and (4) determine which of these instruments would be best suited to be used in healthcare settings.

Background

Compassion has been recognized as a fundamental dimension of quality healthcare.

Methods

Several scientific databases were consulted for relevant records published up to December 16th, 2021. In accordance with PRISMA guidelines, 64 studies were included.

Results and conclusions

while existing instruments, validated in Spanish, allow for the measurement of self-compassion or compassion to others, there are no valid and reliable measures currently available in Spanish to measure patient-reported compassion.

Relevance to clinical practice

In order to ensure and promote compassion in the health care context, it is essential to have a valid and reliable tool to measure this construct in a patient-informed way, and this is currently not possible in the Spanish-speaking context because of the lack of such an instrument in Spanish.

Reducing neuroendocrine psychosocial stress response through socio-emotional dyadic but not mindfulness online training

Introduction

Stress-related diseases pose significant health risks and show wide prevalence. Empirical evidence suggests that contemplative practices, such as socio-emotional dyadic mental exercises, hold promise in mitigating the adverse effects of stress and promoting psychosocial well-being. This study aimed to investigate the differential effects of two online contemplative mental training programs on the psychosocial stress response: the first involved classic mindfulness practices, while the second incorporated a socio-emotional dyadic approach known as Affect Dyad.

Methods

The study was conducted as part of the longitudinal CovSocial project's phase 2 in the context of the COVID-19 pandemic. 140 individuals participated in the Trier Social Stress Task (TSST), where the psychosocial stress response was assessed with cortisol saliva samples and subjective stress questionnaires in a cross-sectional design after the active training groups finished their intervention period. Participants were randomly assigned to the socio-emotional training group, mindfulness-based training group, or a control group that did not receive any training. Both training programs consisted of a ten-week intervention period with a daily 12-minute app-based mental training practice and weekly 2-hour online coaching sessions led by mental training teachers.

Results

Results showed that the socio-emotional Dyad group but not the mindfulness-based group exhibited significantly lower cortisol levels at 10, 20, 30, and 40 minutes after the stressor as well as lower total cortisol output compared to the control group during the TSST, indicating a reduced hormonal stress response to a social stressor. Subjective markers did not show differences between the three groups.

Discussion

These findings indicate that the daily socio-emotional dyadic practice, which emphasizes non-judgmental and empathic listening as well as the acceptance of challenging emotions in the presence of others within one's daily life context, may serve as a protective factor against the adverse effects of psychosocial stress triggered by the fear of negative social judgments. Given the high prevalence of stress-related diseases, such online mental training programs based on dyadic practices may thus represent an efficient and scalable approach for stress reduction.

10-Week Trajectories of Candidate Psychological Processes Differentially Predict Mental Health Gains from Online Dyadic versus Mindfulness Interventions: A Randomized Clinical Trial

Background: App-based contemplative interventions, such as mindfulness-based interventions, have gained popularity for the promotion of mental health; however, the understanding of underlying intervention-specific mechanisms remains limited, especially related to novel inter-relational dyadic practices. Methods: We tested (n = 253) seven putative mechanisms underlying two brief (daily 12-min) online mental interventions: attention-focused mindfulness and socio-emotional partner-based, both supported by weekly online coaching. Weekly self-reports of rumination, worry, psychological flexibility, affective control, social support, acceptance, and mindfulness were obtained over 10 weeks of intervention, and depression, anxiety, and resilience were assessed as pre- and post-intervention outcomes. Results: Significant week-to-week reductions in rumination and increases in psychological flexibility were observed in both interventions. Only attention-based practice led to temporal reductions in worry, and only socio-emotional dyadic practice led to temporal increases in affective control. Mediation analyses with slopes of weekly variables as mediators detected no significant indirect effects. However, exploratory moderation analyses revealed that intervention-related reductions in depressive symptomatology and anxiety vulnerability and increases in resilience were predicted by weekly increases in acceptance and affective control in the socio-emotional dyadic group, and by weekly reductions in rumination and worry in the mindfulness group. Limitations of the study include reliance on brief self-report measures, relatively small sample size, and absence of long-term follow-up assessments indicating the need for future well-powered longitudinal studies comparing intervention modalities. Conclusions: We present preliminary evidence for practice-specific active ingredients of contemplative interventions, which can be leveraged to enhance their efficiency for mental health.

Training-related improvements in mental well-being through reduction in negative interpretation bias: A randomized trial of online socio-emotional dyadic and mindfulness interventions

BACKGROUND

Effects of online contemplative practices, especially partner-based practices, on psychological well-being remain mixed, with sparse understanding of potential affective-cognitive mechanisms. The study aimed to assess the efficacy of two online contemplative interventions in improving depression, anxiety, emotion regulation (ER), and resilience, and to evaluate the mechanistic role of negative attention and interpretation biases.

METHODS

Employing a randomized controlled design (n = 285), we compared the efficacy of 10-week online mindfulness-based and partner-based socio-emotional dyadic interventions, both supported by weekly coaching sessions. Mental health aspects were assessed using validated self-report measures and negative biases using the mouse-contingent Scrambled Sentences Task.

RESULTS

Both interventions, compared to waitlist control, led to reductions in depression and ER difficulties, while trait anxiety decreased only after mindfulness training. Increases in multidimensional resilience were observed only after socio-emotional training and in stress recovery only after mindfulness-based training, both compared to waitlist control. Socio-emotional training led to significant reductions in negative interpretation bias and this mediated reductions in depression and trait anxiety. Neither training led to reductions in state anxiety or negative attention bias.

LIMITATIONS

The subclinical nature and overrepresentation of females in the sample limits generalizability.

CONCLUSIONS

Findings indicate that online mindfulness-based and socio-emotional partner-based interventions, supported by online coaching sessions, can reduce depression and ER difficulties. Though mindfulness practice reduced trait anxiety and enhanced stress recovery, socio-emotional training increased multidimensional resilience. Socio-emotional training reduced negative interpretation bias, which emerged as an intervention-specific mechanism. These findings highlight the potential benefits of online contemplative intervention approaches for psychological well-being.

The path of ideological and political education in fulfilling the function of psychological nurturing

Introduction

The risk of college students facing psychological problems, such as stress, anxiety, and depression, has increased, which may have a negative impact ontheir academic performance and overall well-being, especially after the outbreakof the pandemic.

Methods

This paper summarizes the potential psychological issues thatuniversity students may face and the corresponding coping measures. Basedon this, a theoretical model of ideological and political education to enhancepsychological education was established.

Results

There was a total of 446 participantsin the study, with a mean age of 21.4 years and 44.6 per cent male. With 406 valid survey responses, the theoretical model was examined using the structuralequation modeling method. The results showed that education and teaching, practical activities, counseling services, prevention and intervention, and multilevelplatforms are effective measures to protect the psychological health ofuniversity students.

Discussion

Based on the insights gained from this study, policies canbe implemented to help university students improve their mental health andinspire higher education institutions to prioritize psychological education.

Assessing the mindfulness predictors of mental health: does mindfulness practise or dispositional mindfulness better protect young peoples' mental health?

Background

University is an important time in a young person's life. Although it is a time of exploration, self-discovery and socialising, it is also a time of increased vulnerability to mental health problems such as anxiety and depression. Studies have shown that engagement in mindfulness activities can have a positive effect on mental health. However, research is limited in its scope in particular in relation to stressful (transitional) periods of life.

Methods

The current study aims to address this issue by providing evidence on the predictive impact of both mindfulness practice and 'dispositional' (or trait) mindfulness on students' mental health. In total, we gathered data from 190 first-year students.

Results

A multiple regression was utilised for data analysis. This showed that 'dispositional' mindfulness, but not mindful activity had a significant impact on mental health scores.

Conclusion

This provides data for future research into the effectiveness of mindfulness interventions for student adaptation to university and potential interventions.

A randomized controlled pilot trial of brief online mindfulness training in young drivers

OBJECTIVE

Driver distraction contributes to fatal and injury crashes in young drivers. Mind wandering (MW) is a covert form of distraction involving task-unrelated thoughts. Brief online mindfulness training (MT) may reduce unsafe driving by enhancing recognition (meta-awareness) of MW and reducing its occurrence. This pilot trial tested these proposed mechanisms of MT and explored its specificity of action, effects on driving behaviour in simulation, as well as intervention adherence and acceptability in young drivers.

METHODS

A pre-post (T1, T2), randomized, active placebo-controlled, double-blinded design was used. Twenty-six drivers, aged 21-25, received either brief online MT (experimental) or progressive muscle relaxation (PMR, control) over 4-6 days. A custom website blindly conducted randomization, delivered interventions, administered questionnaires, and tracked adherence. At T1 and T2, a simulator measured driving behaviour while participants indicated MW whenever they recognized it, to assess meta-awareness, and when prompted by a thought-probe, to assess overall MW.

RESULTS

MT reduced MW while driving in simulation. The MT group reported higher state mindfulness following sessions. Motivation did not account for MW or mindfulness results. MT and meta-awareness were associated with more focus-related steering behaviour. Intervention groups did not significantly differ in adherence or attrition. No severe adverse effects were reported, but MT participants reported more difficulty following intervention instructions.

CONCLUSION

Results support a plausible mechanism of MT for reducing MW-related crash risk (i.e., reduction of MW) in young drivers. This preliminary evidence, alongside promising online adherence and acceptability results, warrants definitive efficacy and effectiveness trials of online MT.

Wellbeing Convene during COVID-19: A pilot intervention for improving wellbeing and social connectedness for staff, students, residents, and faculty

Background

Canada is facing its worst crisis among healthcare workers in recent healthcare history. Anxiety, depression, suicidal ideation, and severe burnout are higher than before the COVID-19 pandemic. University Faculties of Medicine (FoMs) are vital to healthcare systems. Not only are they responsible for training personnel, but clinicians and staff from FoMs often work directly within healthcare systems. FoMs include students, staff, residents, faculty members, residents, researchers, and others, many experiencing higher stress levels due to pandemic tensions. Most FoMs emphasize cognitive and psychomotor learning needs. On the other hand, affective learning needs are not as well addressed within most FoMs. Finding innovative means to ameliorate mental and emotional health status, particularly at this critical juncture, will improve health and wellness, productivity, and retention. This article discusses a pilot program, Wellbeing Convene during COVID-19, in a Canadian FoM, which aimed to (1) provide staff, faculty, residents, and students with a toolkit for greater wellbeing and (2) build a sense of community during isolating times.

Results

Participants found the program beneficial in both regards. We recommend that these kinds of programs be permanently available to all members in FoMs, at no cost. Wellness programs alone, however, will not solve the root causes of mental and emotional stress, often based on concerns related to finances, hierarchical workplace structures, and nature of the work itself, among other factors.

Conclusion

Addressing the mental and emotional health of people in FoMs is vital to improving productivity and reducing stress of FoMs, healthcare professionals, and, ultimately, patients.

The effect of brief digital mindfulness-based interventions on increasing online charitable behavior in Chinese adolescents

Digital mindfulness-based interventions (d-MBIs) have garnered significant research interest in recent years due to their psychological benefits. However, little is known about their impact on prosocial behaviors. This study investigates how d-MBIs impact prosocial behaviors where time spent is money, with Chinese adolescents as the subjects, through an online charity task (www.freerice.com). 119 students from a high school in China, who were inexperienced with mindfulness meditation, participated in this randomized controlled trial. The d-MBI group (N = 39) received online MBI guidance, while the face-to-face mindfulness-based intervention (f-MBI, N = 43) group underwent mindfulness intervention under personal tutors. The active control group (N = 37) completed a crossword task. Data analysis first involved repeated measures variance analysis, including pre-and post-intervention assessments. Subsequently, a two-way variance analysis was performed, with gender (female and male) and group (d-MBI, f-MBI, active control) as independent variables and the number of grains as dependent variables for the three groups of participants. Results showed that d-MBIs effectively improved empathy and compassion in Chinese adolescents, leading to increased rice donations to the United Nations World Food Program. These results underscore the positive effect of d-MBIs on prosociality and suggest their applicability in beneficial real-world situations involving prosocial behaviors, extending beyond previous research primarily conducted in artificial and hypothetical scenarios.

Association Between Pandemic Fatigue and Subjective Well-Being: The Indirect Role of Emotional Distress and Moderating Role of Self-Compassion

Objectives: As a stressor in the context of COVID-19 pandemic fatigue is associated with well-being. However, how pandemic fatigue is associated with well-being and what protective factors buffer this negative effect are under investigated. Based on the stress process model and emotion regulation theory, the study examined the indirect effect of pandemic fatigue on subjective well-being through emotional distress and the buffering effect of self-compassion. Methods: Data were collected from 1,162 university students (M _age = 21.61 ± 2.81, female 35.71%) through an online survey. Indirect effect analysis and conditional process analysis were conducted by the SPSS macro PROCESS. Results: Indirect effect of pandemic fatigue on subjective well-being through emotional distress was identified and self-compassion moderated the association between pandemic fatigue and emotional distress. The indirect effect of pandemic fatigue was weaker among participants with high levels of self-compassion than among those with low levels of self-compassion. Conclusion: Pandemic fatigue was negatively associated with subjective well-being through emotional distress at all levels of self-compassion. The findings deepen our understanding of the link between pandemic fatigue and well-being while considering the indirect role of emotional distress and protective function of self-compassion.

A multicenter feasibility study on implementing a brief mindful breathing exercise into regular university courses

Practicing mindfulness is associated with stress reduction and with positive effects in the context of learning and teaching. Although effects on student populations have been studied extensively, there are few studies implementing mindfulness exercises in university courses directly. For this reason, we aimed to investigate whether the use of a brief mindfulness exercise in regular university courses, guided by the lecturers, is feasible and has immediate effects on the students' mental states. We conducted a preregistered multicenter study with one observational arm, following an ABAB design. In total, N = 325 students from 19 different university courses were included at baseline and n = 101 students at post measurement. Students were recruited by N = 14 lecturers located in six different universities in Germany. Lecturers started their courses either by guiding a brief mindfulness exercise (intervention condition) or as they regularly would, with no such exercise (control condition). In both conditions, the mental states of students and lecturers were assessed. Over the semester, n = 1193 weekly observations from students and n = 160 observations from lecturers were collected. Intervention effects were analyzed with linear mixed-effects models. The brief mindfulness exercise, compared to no such exercise, was associated with lower stress composite scores, higher presence composite scores, higher motivation for the courses, as well as better mood in students. Effects persisted throughout a respective course session. Lecturers also reported positive effects of instructing mindfulness. Implementing a brief mindfulness exercise in regular university teaching sessions is feasible and has positive effects on both students and lecturers.

Feasibility and Acceptability of an Online Mindfulness-Based Intervention for Stress Reduction and Psychological Wellbeing of University Students in Pakistan: A Pilot Randomized Controlled Trial

The rise in mental health concerns of university students is causing a serious hinderance to their wellbeing, impeding their functioning. The socio-economic and political friction in low- and middle-income countries adds to their vulnerability and calls for a cost-effective indigenous intervention. Consequently, this study aimed to inform a large definitive trial by assessing the feasibility and acceptability of a randomized controlled trial (RCT) design evaluating a culturally adapted online Mindfulness Training Course (MTC) used to improve stress and wellbeing among Pakistani university students. A two-arm pilot randomized controlled trial was conducted. University students (n = 156) were randomly assigned to either the MTC group (n = 80) or Wait-list (WL) control group (n = 76) and completed baseline and post-intervention self-report measures for mindfulness, stress and psychological wellbeing. Additionally, semi-structured interviews were conducted with consenting MTC group participants (n = 18) to explore their views about MTC, employing reflexive thematic analysis. Of 80 participants randomized to the MTC group, 32 completed the course, whereas, from the 156 randomized participants, 102 completed assessment surveys. Feasibility and acceptability indicators showed high recruitment, compliance, and adherence to MTC, with practical steps for randomization and online data collection. Further results showed higher levels of mindfulness and psychological wellbeing and lowered stress levels in the MTC group compared to the control group. The attrition and dropout rates were high; however, the feedback from participants who completed the MTC was highly positive and encouraging. In conclusion, if the trial proceeds with increased outreach in a large-scale RCT, the recruitment might be revised to reduce attrition rates. Further recommendations are discussed.

The relationship between mindfulness and mental health among Chinese college students during the closed-loop management of the COVID-19 pandemic: A moderated mediation model

To prevent the spread of the COVID-19 epidemic on campus, universities in outbreak areas in China can implement closed-loop management.

OBJECTS

This study aimed to explore the relationship between mindfulness and mental health of college students under closed-loop management.

MEASURES

11,939 college students from a university in Changsha, China participated in the online survey during the closed-loop management period. The Chinese version of Perceived Stress Scale, the Emotion Regulation Questionnaire-Cognitive Reappraisal, the Mindful Attention Awareness Scale, the 7-item General Anxiety Disorder questionnaire, and the 9-item Patient Health Questionnaire were administered to the college students.

RESULTS

We found that mindfulness was negative association with mental health during the closed-loop management period. Perceived stress mediated the relationship between mindfulness and mental health. Cognitive reappraisal moderated the relationship between mindfulness and perceived stress. Specifically, when the level of mindfulness is the same, individuals with more cognitive reappraisal tend to experience a less perceived stress.

CONCLUSION

The results of this study are of great significance to improve the mental health of college students during closed-loop management period.

Association between self-compassion and cyber aggression in the COVID-19 context: roles of attribution and public stigma

Self-compassion is negatively associated with aggressive behaviors. However, the association between self-compassion and cyber aggression toward stigmatized people (e.g., people infected with COVID-19) has not been investigated in the COVID-19 context and the mechanism underlying this association remains underexplored. On the basis of emotion regulation theory and attribution theory, this study examined the indirect effects of self-compassion on cyber aggression toward people infected with COVID-19 through attribution and public stigma of COVID-19. Data were collected from 1162 Chinese college students (415 male, mean age = 21.61 years). Participants completed an online questionnaire including measurement of the key variables and basic demographic information. Results indicated that self-compassion was negatively associated with cyber aggression through the lower attribution of COVID-19 and lower public stigma of COVID-19. A sequential pathway from the attribution of COVID-19 to public stigma of COVID-19 was identified in the relationship between self-compassion and cyber aggression. Our findings are consistent with emotion regulation theory and attribution theory, which posit that emotion regulation strategies are associated with interpersonal mistreatment through cognitive pathways. These findings suggest that emotional self-regulation strategies can be used to reduce cyber aggression toward stigmatized people by reducing attribution and public stigma in the COVID-19 context. Self-compassion improvement could be target for the interventions aiming at alleviating public stigma and interpersonal mistreatment toward stigmatized people.

Initial risk factors, self-compassion trajectories, and well-being outcomes during the COVID-19 pandemic: A person-centered approach

Introduction

We investigated whether initial risk classes and heterogeneous trajectories of self-compassion over the course of the pandemic may impact well-being outcomes 1 year into the pandemic.

Methods

A large, representative sample of Canadians (N = 3,613; 50.6% women) was sampled longitudinally over 11 waves (April 2020-April 2021), using a rolling cross-sectional survey design. Analyses were conducted in three steps: (1) latent class analysis to identify heterogeneity in risk factors (sociodemographic, cognitive-personality, health-related) early in the pandemic, (2) latent class growth analysis (LCGA) to identify longitudinal self-compassion trajectories, and (3) GLM to examine effects of risk factor classes and self-compassion trajectories, as well as their interaction, on later well-being (mental health, perceived control, life satisfaction).

Results and Discussion

Four risk factor classes emerged, with 50.9% of participants experiencing low risk, 14.3% experiencing multiple risks, 20.8% experiencing Cognitive-Personality and Health risks, and 14.0% experiencing sociodemographic and Cognitive-Personality risks. Four self-compassion trajectories also emerged, with 47.7% of participants experiencing moderate-high self-compassion that decreased then stabilized, 32.0% experiencing moderate self-compassion that decreased then stabilized, 17.3% experiencing high and stable self-compassion across time, and 3.0% experiencing low and decreasing self-compassion. Comparisons of well-being outcomes 1 year post-pandemic indicated that higher levels of self-compassion over time may protect against the impact of initial risk on well-being outcomes. Further work is still needed on heterogeneity in experiences of risk and protective factors during stressful life events.

Dispositional mindfulness and mental health among Chinese college students during the COVID-19 lockdown: The mediating role of self-compassion and the moderating role of gender

College students' mental health has been seriously impacted during the global COVID-19 lockdown. There is evidence that dispositional mindfulness is beneficial to mental health. However, few studies have looked at the relationship between dispositional mindfulness and mental health from the standpoint of self-compassion. Furthermore, it is unclear under what circumstances dispositional mindfulness is linked to mental health during COVID-19 lockdown. To fill this gap, the current study investigated self-compassion as a possible mediating factor and gender as a possible moderating effect between dispositional mindfulness and mental health. The sample included 1,018 Chinese university students during the COVID-19 lockdown (M age = 20.12; SD age = 1.17) who had completed self-report questionnaires on dispositional mindfulness, self-compassion, and mental health. According to the findings of mediation analysis, self-compassion partially mediated the relationship between dispositional mindfulness and mental health. The moderating analysis also revealed significant moderating effects of dispositional mindfulness, self-compassion, and mental health. Male college students' mental health was significantly better protected, and the buffering effects of dispositional mindfulness and self-compassion on their mental health were significantly stronger than those of female college students. These findings advance our understanding of the process and mechanism between dispositional mindfulness and mental health, broadened and deepened the understanding of the relationship between dispositional mindfulness and mental health, as well as the mediating role of self-compassion and the moderating role of gender, and offer practical guidance for improving college students' mental health during the COVID-19 lockdown.

Risk and resilience factors associated with college students' psychological distress and PTSD symptoms during the COVID-19 pandemic

Objective: College students are experiencing pronounced mental health difficulties as a result of the COVID-19 pandemic. Little is known, however, about underlying risk and resilience factors contributing to students' psychological health during this time. The current study examined mindfulness, resilience, coping, emotion regulation, and daily hassles as possible predictors of COVID-19 concern, psychological distress, and PTSD symptoms in a sample of college students. Participants: One hundred and thirty-five undergraduate college students participated in this study during the COVID-19 pandemic. Methods: Participants completed a series of self-report questionnaires. Results: Risk and resilience factor hierarchical regression models were run separately to predict the three outcomes. Daily hassles, ethnicity, and first-generation college student status predicted greater COVID-19 concern; daily hassles and difficulties with emotion regulation predicted greater psychological distress; daily hassles, difficulties with emotion regulation, avoidant coping, and problem-focused coping positively predicted PTSD symptoms. Acting with awareness mindfulness and continuing-generation college student status predicted lower COVID-19 concern; acting with awareness mindfulness, nonjudging mindfulness, and resilience predicted lower psychological distress; acting with awareness mindfulness, nonjudging mindfulness, and resilience also predicted lower PTSD symptomatology. Conclusions: Identifying underlying factors associated with college students' mental health during the COVID-19 pandemic may facilitate the development and implementation of targeted preventative interventions aimed at promoting well-being in this uniquely vulnerable population.

The Influence of Integrating the Basic Theory of Marxism into College Students' Mental Health Under the Data Driven and Internet Environment

Introduction

The Internet has caused a great impact on everyone's psychology. Under this background, it is necessary to study whether Marxism can affect college students' mental health.

Methods

Firstly, the introduction explains China's concern for college students' mental health and the research achievements. Then, in the method part, this paper analyzes the thoughts and connotations of basic Marxist theory, quality education, and mental health education, mainly studying the changes brought by the Internet to the development of Marxism and the mechanism and influence of Marxism on mental health education. The questionnaire survey is used to investigate the mental health of college students and the current situation of Marxist ideological and political education.

Results

The results show that most college students are not interested in ideological and political education, and from the investigation results of five major factors of life stressors and five indicators of psychological crisis factors, it is concluded that college students' life stressors are the risk factors that induce psychological crisis tendency.

Discussion

The discussion part shows that it is necessary to cultivate the core quality of college students' development through Marxism, and pay attention to actively preventing and intervening the psychological crisis of college students. This paper analyzes and confirms the effectiveness of Marxist theory on the development of mental health, injects fresh blood into the future ideological and political education and the research of college students' mental health education, and provides theoretical and experimental reference and new ideas. The research has practical reference value for promoting the deep integration of data-driven Marxist basic theory and college students' mental health monitoring.

Effect of online mindfulness-based physical exercise program on psychological well-being and life satisfaction during the Covid-19 pandemic

The aim of this study was to examine the effectiveness of a mindfulness-based physical exercise program on university students' psychological well-being and life satisfaction. In the study, a randomized control group pre-test, post-test, and follow-up test design was used. The study group consisted of 60 students (30 in an experimental group and 30 in a control group) continuing their education in different faculties of a foundation university during the Covid-19 pandemic in Turkey. A personal information questionnaire, Psychological Well-Being Scale and Life Satisfaction Scale were used to collect the study data. The Mindfulness-Based Physical Exercise Program was implemented in the experimental group, once a week for 8 sessions. The results suggested significant differences between the psychological well-being and life satisfaction post-test scores of the experimental and control groups in favor of the experimental group. In the sub-dimensions of psychological well-being, significant differences were found between the experimental and control groups in post-test scores of environmental mastery, personal growth, and purpose in life. There was no significant difference between the psychological well-being, positive relationships with others, autonomy, environmental mastery, purpose in life, and self-acceptance sub-dimensions except personal growth sub-dimensions, and life satisfaction post-test and follow-up test scores of the university students in the experimental group. In the post-test comparisons of two groups, a significant difference was found between total psychological well-being, environmental mastery, personal growth, purpose in life, and self-acceptance, in favor of the experimental group.

College Student Resilience During COVID-19: Examining the Roles of Mindfulness, Compassion, and Prosocial Behavior

The present study examined factors associated with resilience in college students during the COVID-19 pandemic. Participants were undergraduates at a large Midwestern university in the USA (N = 848). Hierarchical linear regression analyses examined self-reported pandemic-related adversity, community COVID-19 case rates, mindfulness, compassion, and prosocialness to determine the strongest associates of resilience. Findings demonstrated that mindfulness was the only psychological process of interest significantly associated with resilience, so specific facets were further explored in a regression analysis. Specifically, higher levels of the following mindfulness skills were associated with greater resilience: ability to describe internal experiences, to remain aware while engaging in action, and to take a nonreactive stance toward internal experiences. Mindfulness-based interventions may be appropriate for promoting resilience in college students during the COVID-19 pandemic.

The efficacy of online mindfulness-based interventions in a university student sample: Videoconference- or podcast-delivered intervention

The increasing mental health issues among university students during the COVID-19 pandemic and the challenges of delivering face-to-face interventions during lockdowns have increased the demand for online interventions. The report presents results from a randomized controlled trial investigating the benefits of online mindfulness interventions delivered by videoconference or podcast during the early phase of the pandemic in Germany. Fifty university students were randomized to a mindfulness intervention conducted by videoconference (n = 25) or to an unguided training provided by podcasts (n = 25). All students participated in a 7-week mindfulness intervention. Outcome measures included mindfulness, depression, anxiety, and life satisfaction preintervention and postintervention. The study showed a larger reduction in depression in the videoconferencing group than in the podcast group across per protocol (PP) and intention-to-treat (ITT) analyses. There was a significant increase in mindfulness (PP and ITT samples) and life satisfaction (ITT sample) in both groups. The frequency of home practice was related to positive changes in outcomes but only for the videoconferencing group. The results suggest that mindfulness training delivered via videoconferencing can be a viable option to address depressive symptoms among students. However, both interventions were effective in increasing mindfulness and life satisfaction.

Promoting University Students' Mental Health through an Online Multicomponent Intervention during the COVID-19 Pandemic

The mental health of university students is a serious public health issue. The alarming trend of high levels of untreated psychological distress observed during the COVID-19 pandemic highlights the need for prevention programs. Digital tools are a promising means of delivering such programs. Web-based programs are acceptable and effective at improving mental health problems and general mental well-being. However, the usefulness of such digital prevention approaches to address the multiple issues raised by the COVID-19 pandemic needs to be tested. The current study assessed the effectiveness of an 8-week online intervention, integrating a variety of evidence-based strategies for improving French university students' mental health. Students were assigned to: (1) the online self-help program ETUCARE (n = 53), or (2) the control condition (n = 50). All the participants completed pre- and post-intervention questionnaires that assessed mental health problems and psychological well-being. The findings revealed that, compared to the control group, participation in the online program was associated with higher levels of psychological well-being post-test and fewer clinical symptoms of psychological distress, anxiety, and alcohol consumption. These preliminary findings suggest that the ETUCARE program is a promising multicomponent intervention to buffer the mental health consequences of the COVID-19 pandemic in French university students.

Living through the psychological consequences of COVID-19 pandemic: a systematic review of effective mitigating interventions

OBJECTIVE

This review assesses interventions and their effectiveness in mitigating psychological consequences from pandemic.

METHOD

Published English literatures were searched from four databases (Medline, PubMed, Embase and PsycINFO) from January 2020 and September 2021. A total of 27 papers with 29 studies (one paper reported three studies) met inclusion criteria. Cochrane risk-of-bias tool is applied to assess the quality of all randomised controlled trials (RCT).

RESULTS

All studies were recently conducted in 2020. Publications were from high-income (13, 44.8%), upper middle-income (12, 41.4%) and lower middle-income countries (3, 10.3%) and global (1, 3.5%). Half of the studies conducted for general population (51.7%). One-third of studies (8, 27.6%) provided interventions to patients with COVID-19 and 20.7% to healthcare workers. Of the 29 studies, 14 (48.3%) were RCT. All RCTs were assessed for risk of biases; five studies (15, 35.7%) had low risk as measured against all six dimensions reflecting high-quality study.Of these 29 studies, 26 diagnostic or screening measures were applied; 8 (30.9%) for anxiety, 7 (26.9%) for depression, 5 (19.2%) for stress, 5 (19.2%) for insomnia and 1 (3.8%) for suicide. Measures used to assess the baseline and outcomes of interventions were standardised and widely applied by other studies with high level of reliability and validity. Of 11 RCT studies, 10 (90.9%) showed that anxiety interventions significantly lowered anxiety in intervention groups. Five of the six RCT studies (83.3%) had significantly reduced the level of depression. Most interventions for anxiety and stress were mindfulness and meditation based.

CONCLUSIONS

Results from RCT studies (11%, 78.6%) were effective in mitigating psychological consequences from COVID-19 pandemic when applied to healthcare workers, patients with COVID-19 and general population. These effective interventions can be applied and scaled up in other country settings through adaptation of modes of delivery suitable to country resources, pandemic and health system context.

From Mental Health Crisis to Existential Human Suffering: The Role of Self-Transcendence in Contemporary Mindfulness

Our paper addresses the so-called college mental health crisis and the adoption of the strategy of mindfulness-based interventions. We offer a critique of their underlying medical–therapeutic paradigm by engaging the notion of self-transcendence in Viktor Frankl’s Existential Analysis and Buddhism in dialogue. We argue that the current mindfulness movement has decontextualized and appropriated mindfulness from its Buddhist foundations in favor of a model that offers objectively verifiable biophysical and mental benefits. Self-transcendence, whether from the perspective of Buddhism or Frankl’s work, offers what we feel is an existentially viable path forward for college students, in lieu of the current paradigm promoted by those advocating use of these mindfulness-based interventions. We conclude by considering Existential and Buddhist notions of self-transcendence in dialogue, suggesting they offer an educational practice worthy of implementation.

Online Mindfulness Intervention, Mental Health and Attentional Abilities: A Randomized Controlled Trial in University Students During COVID-19 Lockdown

The COVID-19 pandemic has led to worldwide restrictive measures, raising concerns about mental health in young adults who were not particularly vulnerable to the virus itself. This study investigated the impact of these restrictions on mental and cognitive health of university students, and tested the efficacy of a brief online mindfulness meditation intervention in countering psychological distress and improving attentional abilities. Ninety-six university students forced into remote learning due to COVID-19 pandemic restrictions and with no experience in meditation were randomly assigned to either a passive control group (n = 48) or to an experimental group (n = 48) following daily, for 17 days, an online mindfulness intervention (10–20 min per day). Due to drop-out, 38 participants in each group were finally analyzed. Pre- and post-tests assessed participants’ mental health (psychological well-being, depression, anxiety, stress) and attentional abilities. The analysis of baseline data in comparison with normative scores and pre-pandemic statistics confirmed the expected psychological distress, but it did not reveal any attentional deficits in our participants. Pre-post change scores analyses showed a reduction in stress (p = 0.006, η_p² = 0.10), anxiety (p = 0.002, η_p² = 0.13), and depression (p = 0.025, η_p² = 0.07), and an improvement in well-being (p = 0.013, η_p² = 0.12) in the experimental group, but not in the control group. In both groups, no significant effect was found on attentional abilities. Our results confirmed the psychological vulnerability of higher education students in the midst of the remote learning period during the second COVID-19 lockdown in France, while suggesting preservation of attentional functioning. Although the tested mindfulness intervention did not enhance the attentional abilities in already good performing students, it did promote their mental health. This study offers additional evidence on the feasibility and efficacy of mindfulness-based interventions in students during psychologically straining periods, like the COVID-19 pandemic.

Online Short-Term Mindfulness-Based Intervention During COVID-19 Quarantine in Italy: Effects on Wellbeing, Stress, and Anxiety

To limit the first spread of COVID-19 in March 2020, the Italian government imposed strict lockdown measures to the population. Despite necessary to reduce the virus transmission and the burden to the hospitals, social isolation has caused detrimental effects on psychological wellbeing and mental health. Moreover, during this period, it was also difficult to deliver psychological treatments and psychiatric assistance. A short (a weekly session for 9 weeks) mindfulness-based meditation program, named Integral Meditation (IM), was administered entirely online to healthy adults from Italy. This is a two-groups pre–post-quasi-experimental study in which the two groups, treated and control, were not randomized. Through matching procedures aimed at overcoming the absence of randomization, we analyzed a sample of 84 subjects (42 for each group). By applying linear mixed effect models, we tested the hypothesis of a beneficial effect of IM on wellbeing, perceived stress, and state anxiety, as measured by three self-reported questionnaires (WEMWBS, PSS, and STAI-X1, respectively), assuming that this effect could be different according to the level of baseline trait anxiety, as measured by STAI-X2. The results showed a statistically significant effect of STAI-X1 (β = −8.24 [95%CI −15.39; −1.09], p = 0.02) and WEMWBS (β = 4.61 [95%CI 0.94; 8.29], p = 0.01) in the higher trait anxiety subgroup only. No statistically significant effect of IM was observed for PSS. These results suggest that our IM, delivered online, may increase mental wellbeing and decrease anxiety specifically in subjects with higher trait anxiety.

An analysis of business students’ stressors and their coping strategies in the post-pandemic era

The COVID-19 pandemic has brought a dramatic change in teaching–learning practices in higher education across the world. The post-pandemic era with a new shift of teaching–learning phase raises the concern of students' psychological well-being, especially the novice, i.e., first-year undergraduate students, as first-year students often struggle to adjust to the new environment of higher institutions, thereby depressive symptoms are more prevalent among them. In this regard, a qualitative study was conducted followed by a dyadic approach to explore the symptoms of students’ psychological stressors, their causes, and provide essential remedies for coping with such behaviors in the post-pandemic era. The findings show that students’ stressors were commonly reported due to the academic workload, institutional regulations, lack of resources, and financial constraints. Regarding indications, unusual behavior, lack of confidence, improper sleep, and lack of motivation were identified as the primary symptoms of students’ stress. However, participants reported a lack of understanding regarding stress-related matters. Yet, students and faculty members try to adopt several strategies for reducing such stressors. By examining the perceived psychological stress, indications, and coping behaviors, this study enriches the literature by bridging pragmatic and theoretical gaps regarding students’ stressors of business management. Furthermore, the study mainly suggests that adequate institutional support should be provided to deal with students’ problems that cause stress. Also, universities should organize workshops or seminars to cultivate psychological health awareness among students and faculty members.

A Self-Managed Online Mindfulness Program in a University-Wide Learning Management System Orientation Site: A Real-World Ecological Validation Study

The efficacy of mindfulness-based interventions in randomised-controlled trials and large experimental studies has been demonstrated in university student populations. Whilst these investigations have provided insight into the nature of the delivery of mindfulness-based practices, there has been little research in the implementation of self-managed online student wellbeing and mindfulness programs at university. This ecological validation study conducted in 2020 evaluated a real-world implementation of a large, university-wide, online mindfulness-based program that was accessible fully online via the tertiary institutions’ Learning Management System (LMS) student orientation site. The total sample included 833 participants from a range of disciplines and faculties at Monash University, Australia. At the end of the study, 236 (28.3%) participants were retained and completed the follow-up survey. Participants had the option to engage with the fully self-managed online mindfulness program for a 12-week semester. The mindfulness practices were pre-recorded, audio-guided sessions, and 10–15 min in length. Baseline and end of semester questionnaires included the 14-item Warwick-Edinburgh Mental Wellbeing Scale, 10-item Perceived Stress Scale and the 18-item Five Facet Mindfulness Questionnaire. Participants who engaged with the mindfulness program over 3 or more weeks showed significant improvements in all three outcome measures, and all participants showed significant improvements in wellbeing at the end of semester. Learning analytics obtained via the LMS revealed that 58.6% (n = 489) had not logged into the mindfulness program at all, almost a third (31.0%, n = 259) logged into the program materials once or twice, and 10.2% (n = 85) of the whole sample engaged with the program actively, having logged in three or more times. The total number of student logins peaked in week 2, reduced between week 2 and week 7 and thereafter activity remained stable until the end of the semester. We hypothesise that the changes in wellbeing, stress and mindfulness at the end of the semester seen in the low engagement participants may partly be explained by the circumstances of COVID-19 restrictions improving. This study has revealed and discusses the complexities of student behaviour and implications for implementing an online mindfulness program in the real- world setting of a university.

Cross-cultural validity of the five items Mindful Attention Awareness Scale (MAAS-5) in Peru and Mexico during the COVID-19 pandemic

The Spanish version of the 5-item Mindful Attention Awareness Scale (MAAS-5) is a brief measure of the general tendency to be attentive and aware of experiences in the present moment during daily life. The MAAS-5 has been used in different countries; however, an assessment of its cross-cultural measurement invariance (MI) has not been conducted. Therefore, the study aimed to evaluate the cross-cultural measurement invariance of the MAAS-5 in university students from two countries: Peru and Mexico. A total of 1144 university students from Peru (N = 822) and Mexico (N = 322) responded online to the Spanish version of the 5-item Mindful Attention Awareness Scale (MAAS-5). A multigroup confirmatory factor analysis was performed. Measurement invariance tests the hypothesis that the model behind a set of scores is comparable between groups. The results showed that the unidimensional structure of the MAAS-5 is the same between Peruvian and Mexican university students. Therefore, it is suggested that university students from both countries conceptualize the mindfulness in a similar way. As a result, the MAAS-5 can be used to compare differences between countries. No significant differences were observed in the MAAS-5 score between Peruvian and Mexican university students. The present study contributes to a better understanding of the psychometric properties of the MAAS-5 by presenting MI results in two Latin American countries. Implications of the findings are discussed, which will facilitate a more solid and reliable use of the MAAS-5 in future cross-cultural studies.

Analysis of the Predictive Role of Self-Compassion on Emotional Distress during COVID-19 Lockdown

Research has shown that the COVID-19 pandemic has caused a mental health burden worldwide. Most studies have focused on the factors associated with a higher risk of mental health problems, and only a few studies have looked at the potential protective factors. The general objective of this study was to determine whether self-compassion has a protective effect against the risk of mental health problems and especially on perceived infectability. If so, we intended to determine which of the three specific facets of self-compassion (i.e., mindfulness vs. over-identification; self-kindness vs. self-judgment; common humanity vs. isolation;) has the greatest weight in predicting emotional distress. We conducted a cross-sectional study through an online survey completed by 855 participants in Spain. Results confirmed that the three facets of self-compassion reduce the negative correlation between perceived infectability and emotional distress, diminishing its role in predicting emotional distress. These results are discussed in relation to the protective role of self-compassion and the need to further explore the variables associated with a lower risk of mental problems derived from the SARS-CoV-2 pandemic.

A Brief, Daily, Online Mental Health and Well-being Intervention for University Staff During the COVID-19 Pandemic: Program Description and Outcomes Using a Mixed Methods Design

BACKGROUND

The unprecedented changes and isolation measures to contain COVID-19 have had multiple psychological and social impacts, with implications for professional and personal functioning. Evidence-informed interventions that can be rapidly implemented under pandemic conditions to support mental health during such times are urgently needed.

OBJECTIVE

The aim of this study was to determine the acceptability and preliminary outcomes of a daily online mental health promotion program for tertiary education staff during the COVID-19 pandemic.

METHODS

The "Victoria University (VU) Elevenses" program was delivered as an uncontrolled intervention at Victoria University (VU) in the western metropolitan region of Melbourne, Australia. In April 2020, an email invitation was sent to all academic and professional staff inviting them to: (1) participate in the program and (2) opt-in to the research component. The "VU Elevenses" program provided 10-15-minute microinterventions comprising lifestyle and well-being strategies to promote mental health via an online meeting platform at 11 AM each weekday. A mixed methods approach was used to evaluate the program, combining structured questionnaires with semistructured interviews to investigate the experiences of staff who participated in the program.

RESULTS

Between 16 and 90 participants provided weekly program feedback. A total of 106 university staff opted into the longitudinal research component and 10 staff participated in the interviews. Participants reported high levels of satisfaction with sessions and perceived benefits for mental health. Approximately one quarter of participants reported moderate to severe symptoms of depression, anxiety, and stress at baseline, with significant reductions in these symptoms in the first 7 weeks of the program, corresponding with easing in mandatory isolation ("lockdown") restrictions. Symptoms of depression, anxiety, and stress all increased when lockdown measures were reintroduced, but not to the same levels as found during the initial lockdown period. Overall changes in depression and anxiety from baseline to the end of the program were explained by changes in COVID-19-related distress, whereas changes in self-compassion explained changes in stress.

CONCLUSIONS

We show that it is feasible and acceptable to develop and deliver a program of brief interventions in a timely manner, using a simple and accessible online platform. Although participation in the program was initially associated with reduced symptoms of depression, anxiety, and stress, participants' mental health worsened with the reintroduction of a "lockdown" period. However, as symptoms of depression, anxiety, and stress did not return to levels observed at the start of the VU Elevenses program, participation in the uncontrolled intervention may have offered a protective benefit against the impact of the second significant lockdown period.

The engagement of tertiary students with an online mental health intervention during the coronavirus disease 2019 pandemic: A feasibility study

Background

We discuss the feasibility of a brief, online mental health promotion programme for tertiary students and establish recommendations for future programmes.

Methods

The programme ‘Student Elevenses’ was delivered at a tertiary education institution. ‘Student Elevenses’ aimed to promote student wellbeing during the coronavirus disease 2019 crisis, comprised of 10–15-min daily online micro-interventions targeting six lifestyle areas for wellbeing, and was delivered via video conference. Upon programme completion, all students were invited to complete barriers to engagement survey, irrespective of whether they had attended or heard of the programme. Descriptive statistics were calculated for demographics, as well as feasibility and acceptability outcomes including recruitment rates, attendance rates and reported barriers to attendance. Open-ended questions were coded for themes.

Results

Less than 1% of those who consented to participate actually attended the programme, with attendance ranging from 2 to 17 participants. Participants were predominantly female (68%), domestic students (81%) and had a mean age of 29.5 years. The barriers students reported included fixed time, online format, a belief programme would not be helpful, preference for existing supports and perceived impacts of coronavirus disease 2019. Students recommended embedding support within policies/teaching, offering a range of supports and involving students in design.

Conclusion

Barriers to mental health promotion via telehealth should be considered to promote accessibility and acceptability for tertiary students. Future programmes should consider reaching students through mandatory activities (e.g. lectures, tutorials) and should include student consultation and co-design to support the development of programmes that meet student needs and preferences.

A Prospective Study Protocol for a Digital Peer Support Platform to Translate Online Peer Support for Emerging Adult Mental Well-being: A Randomized Controlled Trial (Preprint)

Background

Mental health issues among emerging adults (aged 19-25 years) on a global scale have underscored the need to address their widespread experiences of depression and anxiety. As a result of the COVID-19 pandemic, emerging studies are being directed toward the development and deployment of digital peer emotional disclosure and support for the psychological well-being of emerging adults. However, it is important to explore the implementation and clinical effectiveness, as well as associated mechanisms of change, for optimal approaches in conducting digital peer support interventions for emerging adults’ psychological well-being.

Objective

We describe a randomized controlled trial to evaluate the implementation and clinical effectiveness of Acceset, a digital peer support intervention to address emerging adult mental well-being. The intervention has 2 components. First, the digital peer support training equips befrienders (ie, peers who provide support) to harness 4 components of psychological well-being—mattering, selfhood, compassion, and mindfulness—to provide effective peer support for seekers (ie, peers who seek support). Second, Acceset incorporates psychological well-being digital markers and harnesses community engagement to drive emotional disclosure among peers.

Methods

A total of 100 participants (aged 19-25 years) from the National University of Singapore will be recruited and randomized into 2 arms. In arm 1 (n=50), the seekers will use Acceset with befrienders (n=30) as well as moderators (n=30) for 3 weeks. Arm 2 comprises a wait-listed control group (n=50). A questionnaire battery will be used to monitor seekers and befrienders at 4 time points. These include baseline (before the intervention), 3 weeks (end of the intervention), and 6 and 9 weeks (carryover effect measurement). Implementation outcomes of the intervention will involve evaluation of the training curriculum with respect to adoption and fidelity as well as user acceptability of the Acceset platform and its feasibility for broader deployment. Clinical outcomes will include mattering, selfhood, compassion, mindfulness, perceived social support, and psychological well-being scores.

Results

This protocol received National University of Singapore Institutional Ethics Review Board approval in October 2021. Recruitment will commence in January 2022. We expect data collection and analyses to be completed in June 2022. Preliminary findings are expected to be published in December 2022. The Cohen d index will be used for effect size estimation with a .05 (95% reliability) significance level and 80% power.

Conclusions

This protocol considers a novel digital peer support intervention—Acceset—that incorporates components and digital markers of emerging adult mental well-being. Through the validation of the Acceset intervention, this study defines the parameters and conditions for digital peer support interventions for emerging adults.

Trial Registration

ClinicalTrials.gov NCT05083676; https://clinicaltrials.gov/ct2/show/NCT05083676

International Registered Report Identifier (IRRID)

PRR1-10.2196/34602

Efficacy of the FIBROWALK Multicomponent Program Moved to a Virtual Setting for Patients with Fibromyalgia during the COVID-19 Pandemic: A Proof-of-Concept RCT Performed Alongside the State of Alarm in Spain

FIBROWALK is a multicomponent program including pain neuroscience education, therapeutic exercise, cognitive behavioral therapy and mindfulness training that has recently been found to be effective in patients with fibromyalgia (FM). This RCT started before the COVID-19 pandemic and was moved to a virtual format (i.e., online videos) when the lockdown was declared in Spain. This study is aimed to evaluate the efficacy of a virtual FIBROWALK compared to Treatment-As-Usual (TAU) in patients with FM during the first state of alarm in Spain. A total of 151 patients with FM were randomized into two study arms: FIBROWALK plus TAU vs. TAU alone. The primary outcome was functional impairment. Secondary outcomes were kinesiophobia, anxiety and depressive symptomatology, and physical functioning. Differences between groups at post-treatment assessment were analyzed using Intention-To-Treat (ITT) and completer approaches. Baseline differences between clinical responders and non-responders were also explored. Statistically significant improvements with small-to-moderate effect sizes were observed in FIBROWALK+TAU vs. TAU regarding functional impairment and most secondary outcomes. In our study, the NNT was 5, which was, albeit modestly, indicative of an efficacious intervention. The results of this proof-of-concept RCT preliminarily support the efficacy of virtual FIBROWALK in patients with FM during the Spanish COVID-19 lockdown.

Investigating the Influence of Self-Compassion-Focused Interventions on Posttraumatic Stress: A Systematic Review and Meta-Analysis

Objectives

Self-compassion-focused interventions may be able to decrease posttraumatic stress symptoms. However, previous studies demonstrated mixed effects in which a series of confounders were not systematically quantified. In this study, a systematic review with meta-analysis was conducted to quantify the effects of self-compassion-focused therapies on posttraumatic stress disorder.

Methods

Twelve eligible studies were included after a systematic search of databases. Outcome measures were extracted for posttraumatic stress disorder.

Results

Our data indicated a medium protective effect on posttraumatic stress symptoms (SMD =  − 0.65), with most of the studies (8/12) coming from clinical settings. More importantly, longer interventions were associated with better posttraumatic stress outcomes (p < 0.001). Baseline or changes in self-compassion scores were not associated with posttraumatic stress outcomes post-interventions.

Conclusions

Overall, findings from this meta-analysis quantified the complex influence of self-compassion-focused interventions on posttraumatic stress symptoms and may provide insights for optimizing intervention strategies. 

Systematic Review and Meta-analysis Registration: PROSPERO CRD42020208663.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-021-01732-3.