Prevalence of anxiety and depression symptom, and the demands for psychological knowledge and interventions in college students during COVID-19 epidemic: A large cross-sectional study

Association of perceived stress with changes in physical activity and sitting time before and during COVID-19 pandemic among college students

OBJECTIVE

To examine the association of perceived stress [PS] with physical activity [PA] and sitting time [ST], before and during COVID-19 among US college students. Participants: 592 students from a large Western university (19.08 ± 4.62 years, 76.69% female, 79.39% White) were recruited. Methods: Self-reported online survey was completed in June-December 2020. Analysis included paired T-tests for continuous variables, Pearson Correlation the relationship between PSS, PA, and sitting time before and during COVID-19, and linear mixed models examined the association of outcome variables with PSS, time, and PSS × time. Results. Vigorous, moderate, and light PA decreased by 40%, 35% and 19%, sitting time increased by 52%, and PSS increase by 42% from before to during COVID-19. Conclusions: The perceived stress during COVID-19 may have influenced physical activity and sitting time. Effective health promotion programs and coping strategies are needed to protect college students as campuses reopen during COVID.

The impact of mindfulness training on alleviating COVID-19 fear among international students in China: A quasi-experimental study

This study investigated the effects of mindfulness training on alleviating fear of the COVID-19 epidemic among international students in China during the academic year 2020. The training group participants (N = 41) and the control group participants (N = 44) were surveyed pre-and post-training with the two English questionnaires: The Five-Facet Mindfulness Questionnaire (FFMQ) and the fear of the COVID-19 scale (FCV-19S). The results showed that, regarding the relationship between the two main variables in the study, mindfulness is related negatively to the COVID-19 epidemic. Moreover, compared to the control group, results showed that individuals in the training group demonstrated significant improvements in mindfulness levels and decreased Fear of COVID-19. Thus, findings suggest that a short online mindfulness meditation training may reduce fear of the COVID-19 epidemic.

Changes and predictors of mental health of Chinese university students after the COVID-19 pandemic: A two-year study

BACKGROUND

Psychological repurcussions of COVID-19 pandemic has received wide attention, but there's limited attention paid to psychological recovery afterwards. This study focuses on the changes and predictive factors of mental health of Chinese university students post-pandemic.

METHODS

This study included 1175 Chinese undergraduate students sampled in May 2022 and May-June 2023, right before and after peaks of infections following the end of lockdown policy in China. The participants completed a survey of demographic variables, and three questionnaires: 12-item General Health Questionnaire, Positive Psychological Capital Questionnaire, and Prosocial Tendencies Measure.

RESULTS

The participants sampled in 2023 have significant lower GHQ scores and higher PPQ scores than those sampled in 2022, while there is no significant difference in PTM scores between them. The proportion of participants with GHQ-12 scores exceeding 12 in 2023 showed slightly decrease compared to that in 2022. The infection of significant others, the sense of hope, and PPQ self-efficiency, hope and optimism subscale scores were significantly associated with GHQ-12 scores in 2023, but actual infection or quarantine experience were not.

CONCLUSIONS

The mental health and psychological capital of the university students have been significantly improved within a year. It is worthy to pay attention to the infection of significant others, the sense of hope, and psychological capital in a pandemic to improve the mental health of university students.

LIMITATIONS

Compared to a cross-sectional study, longitudinal research is the better choice for a two-year comparison.

Relationship between Psychosocial Factors and Physical Activity among Undergraduate Students from a South African University

Psychosocial factors such as mental health, motivation, and social support are key determinants of behavior that play a significant role in physical activity participation. Limited studies have investigated the relationship between psychosocial factors and physical activity among university students in Africa. The aim of this study was to determine the relationship between psychosocial factors and physical activity participation among undergraduate university students at a historically disadvantaged university (HDU) in South Africa. This was a cross-sectional study that used convenience sampling (n = 534, majority female, 53.6% with a mean age of 20.69). The study was conducted through an online, self-administered, and hard-copy, valid questionnaire in September 2022. Data on sociodemographic information were collected. Psychosocial factors were assessed using the Depression, Anxiety, and Stress-21 Scale for mental health, the Physical Activity and Leisure Motivation Scale for motivation, and the Perceived Social Support Scale for social support. Physical activity (calculated as MET-min/week) was assessed using the international physical activity questionnaire in short form. Results revealed that almost a third (29%) of undergraduate students were physically inactive, 31.1% were minimally active, and 39.9% were in the health-enhancing category. Physical activity was positively related to stress (r = 0.11, p < 0.05) and anxiety (r = 0.10, p < 0.05). Motivational factors were positively related to psychological condition and others' expectations (r = 0.10, p < 0.05), and depression and others' expectations (r = 0.11, p < 0.05). Results from this study highlighted that psychosocial factors were related to physical activity participation among undergraduate university students. Psychosocial factors should be considered a coping mechanism when implementing health-promoting strategies.

How COVID-19 prevention burnout impacts emotional symptoms among Chinese college students: A moderated mediation model

The current study investigated the relationship between COVID-19 prevention burnout and emotional symptoms (depression and anxiety) among 1,837 Chinese college students and the underlying mechanisms. Results from moderated mediation analysis revealed that the association between COVID-19 prevention burnout and emotional symptoms was mediated by psychological inflexibility (β = 0.20, 95%CI = [0.10, 0.19]). Also, COVID-19 prevention burnout's direct and indirect effects on emotional symptoms were more substantial for students with high susceptibility to emotional contagion than those with low susceptibility. These findings contribute to understanding how COVID-19 prevention burnout relates to emotional symptoms and provide a new perspective for interventions promoting students' psychological flexibility, particularly those with higher susceptibility to emotional contagion.

Effects of the COVID-19 Pandemic on University Students' Mental Health: A Literature Review

This review aims to focus on the effects of COVID-19 on university students' mental health and deepen our understanding of it. The conclusions are based on the review of 32 studies conducted during the pandemic. This review confirms that university students were at high risk for mental health disorders, heightened stress, and increased sleep comorbidities both pre-pandemic and during the pandemic. This literature review confirmed a few universal trends, i.e., increased stress, anxiety, and depression, during the pandemic. The rates of insomnia, obsessive-compulsive disorder, and suicidal ideation also went up. Overall, female students are at a disadvantage in the development of mental health issues. Male students coped better but may be at higher risk for lethality in suicidal ideation. Students with a history of mental health issues and other comorbidities prior to the pandemic had worse outcomes compared to healthy individuals. The study points to a strong positive correlation between fear and increased rates of stress, anxiety, and insomnia. There is also a positive correlation between declining mental health and online learning. A strong negative correlation was present between physical activity and depressive symptoms. These findings are universal across many countries and regions where the studies occurred.

Fear of COVID-19, anxiety, and social support among college students

OBJECTIVE

The present study prospectively examined the association between fear of COVID-19 and anxiety and whether social support moderated this association among college students.

PARTICIPANTS

1,539 students from 11 universities in the United States completed two online surveys, one prior to the COVID-19 pandemic and one during the pandemic.

METHODS

Hierarchical linear regressions assessed the impact of COVID-19 fears and social support on anxiety, after accounting for pre-pandemic anxiety and demographics.

RESULTS

Results supported that adding fear of COVID-19 to the regression model resulted in a significant increase in variance explained over demographics and pre-pandemic anxiety. Social support did not moderate the association between fear of COVID-19 and anxiety.

CONCLUSION

These data underscore the mental health impact of COVID-19 on students and the urgency with which campus-wide initiatives are needed to support students during this unprecedented time.

Emotional experiences and study motivation among Italian university students during the second wave of COVID-19

Objective: This study aimed to investigate the relationships between emotional experiences and study motivation in a group of nonworking and never-infected university students, during the second wave of the COVID-19 pandemic. Participants: Participants (N = 353; aged M = 21.5; SD = 2.8) were mostly female (76.2%) Italian university students. Methods: They completed an online assessment that included self-report measures of fear during the second wave of the COVID-19 pandemic, intolerance of uncertainty, optimism, and study motivation. Results: Our findings showed that older students were more optimistic than younger students. Besides, fear of COVID-19, intolerance of uncertainty, and pessimism predicted worse study motivation. Conclusions: Greater psychological support should be reserved for younger students to prevent emotional experiences that might affect the learning goal.

Mental health profiles and the related socio-demographic predictors in Hong Kong university students under the COVID-19 pandemic: A latent class analysis

While the COVID-19 pandemic has brought about significant challenges to mental health of university students, there is limited research in this area. Particularly, few studies examined the person-centered mental health symptom profiles such as depression and anxiety and the related socio-demographic predictors. Using Latent Class Analysis (LCA), this study investigated the symptom profiles of depression and anxiety in university students in Hong Kong under the COVID-19 pandemic and the socio-demographic predictors. A total of 978 undergraduate students completed an online questionnaire including socio-demographic factors and measures of depression and anxiety during the summer of 2022. The LCA identified three latent classes: "normal" group, "moderate comorbid depression and anxiety" group and "severe comorbid depression and anxiety" group. Multinominal logistic regression showed that comparing with the "normal" group and the "moderate symptom" group, the "severe symptom" group had higher personal financial difficulties and individual/family member unemployment during the pandemic. In contrast, other socio-demographic factors (age, gender, year of study, living status, and COVID-19 infection status) had no significant association with group status. The study contributes to understanding of person-centered depression and anxiety symptom profiles and the risk role of personal financial difficulty in mental health of university students under the pandemic.

Comprehensive geriatric assessment to predict adverse events in elderly patients undergoing posterior lumbar fusion surgery

PURPOSE

Although comprehensive geriatric assessment (CGA) has been used widely, its impact on adverse events in elderly patients has not been fully examined. The present study aimed to investigate the relationships between subcomponents of CGA and adverse events (AEs) in elderly patients undergoing posterior lumbar fusion surgery.

METHODS

A total of 242 eligible elderly patients enrolled. Our CGA included activities of daily living, instrumental activities of daily living, nutritional status, cardiac function, pulmonary function, renal function, frailty, cognition, anxiety, depression, delirium, chronic pain score, comorbidity and polypharmacy. Comprehensive complication index was used to summarize postoperative complications and its severity. Logistic regression was performed to determine the relationships between subcomponents of a CGA and postoperative AEs.

RESULTS

Present study found that female were more vulnerable to have AEs. Postoperative major AEs were associated with delirium (odds ratio (OR): 4.302, 95% confidence interval (CI) 1.720-10.761, p = 0.002), nutritional status (OR: 3.030, 95%CI 1.218-7.541, p = 0.017), cognitive impairment (OR: 4.122, 95%CI 1.179-14.407, p = 0.027), Charlson comorbidity index (CCI) (OR: 4.800, 95%CI 1.852-12.440, p = 0.001) and severe dependent (OR: 3.772, 95%CI 1.116-9.841, p = 0.007). Further analysis showed that delirium (OR: 2.824, 95%CI 1.068-7.467, p = 0.036) and CCI (OR: 3.221, 95%CI 1.184-8.766, p = 0.022) were independently related to major AEs.

CONCLUSIONS

These results indicate that preoperative screening preoperative delirium, cognitive, nutrition and CCI are essential to prevent postoperative major AEs of the surgical elderly.

Surviving the shift: College student satisfaction with emergency online learning during COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) epidemic disrupted education systems by forcing systems to shift to emergency online leaning. Online learning satisfaction affects academic achievement. Many factors affect online learning satisfaction. However there is little study focused on personal characteristics, mental status, and coping style when college students participated in emergency online courses.

AIM

To assess factors related to satisfaction with emergency online learning among college students in Hebei province during the COVID-19 pandemic.

METHODS

We conducted a cross-sectional survey of 1600 college students. The collected information included demographics, psychological aspects of emergent public health events, and coping style. Single factor, correlation, and multiple linear regression analyses were performed to identify factors that affected online learning satisfaction.

RESULTS

Descriptive findings indicated that 62.9% (994/1580) of students were satisfied with online learning. Factors that had significant positive effects on online learning satisfaction were online learning at scheduled times, strong exercise intensity, good health, regular schedule, focusing on the epidemic less than one hour a day, and maintaining emotional stability. Positive coping styles were protective factors of online learning satisfaction. Risk factors for poor satisfaction were depression, neurasthenia, and negative coping style.

CONCLUSION

College students with different personal characteristics, mental status, and coping style exhibited different degrees of online learning satisfaction. Our findings provide reference for educators, psychologists, and school administrators to conduct health education intervention of college students during emergency online learning.

Mental health interventions for atopic dermatitis: knowledge gaps, pilot programmes and future directions

Atopic dermatitis (AD) is associated with high levels of psychosocial burden, often resulting in poor mental health outcomes. Despite this association, few studies have evaluated the efficacy of mental health interventions within this population. Utilization of multidisciplinary and peer-led support, in addition to equipping patients with psychological tools, may be beneficial in improving mental health outcomes. Future research is needed to determine which interventions and formats are desired by, effective in and accessible to patients and caregivers with AD.

Relationship between fruit and vegetable consumption and internet addiction with insomnia and depression as multiple mediators during the COVID-19 pandemic: a three-wave longitudinal study in Chinese college students

BACKGROUND

The relationships between fruit and vegetable consumption (FV) and Internet addiction (IA) in college students still remained unknown together with the internal mechanisms. Given the limitations of previous cross-sectional design, longitudinal research was necessary to be conducted to explore more precise correlations. Using the three-wave data in a longitudinal design, this study aimed to explore the association between FV and IA among Chinese college students and potential multiple mediators of insomnia and depression during the COVID-19 pandemic.

METHODS

A total of 579 college students were recruited during three waves (T1: August 2020; T2: November 2020; T3: February 2021). FV (T1), insomnia (T2), depression (T2) and IA (T3) symptoms were reported. The descriptive statistics of the sociodemographic characteristics and correlation analyses of the study variables were calculated. The significance of the mediation effects was measured conducting a bootstrap method with SPSS PROCESS macro.

RESULTS

FV was negatively correlated with IA, and lower FV predicted higher risk of IA. Depression mediated the association between FV and subsequent IA. Insomnia and depression were multiple mediators, which in turn mediated the links between FV and subsequent IA.

CONCLUSIONS

The three-wave longitudinal study has revealed that FV had indirect effects on IA through individual mediating factor of depression and multiple mediating roles of insomnia and depression sequentially. The policy makers, educators and researchers should pay attention to the impact of the interventions from healthy diet, in order to optimize the coping strategies for preventing college students from IA.

Impact of the COVID-19 Pandemic on the Professional Attitudes of Medical Students: A Pre-Post-Like Study

OBJECTIVE

This study assesses the difference in professional attitudes among medical students, both before and after coronavirus disease 2019 (COVID-19), and identifies the determinants closely associated with it, while providing precise and scientific evidence for implementing precision education on such professional attitudes.

METHODS

A pre-post-like study was conducted among medical students in 31 provinces in mainland China, from March 23, to April 19, 2021.

RESULTS

The proportion of medical students whose professional attitudes were disturbed after the COVID-19 pandemic, was significantly lower than before the COVID-19 pandemic (χ2 = 15.6216; P < 0.0001). Compared with the "undisturbed -undisturbed" group, the "undisturbed-disturbed" group showed that there was a 1.664-fold risk of professional attitudes disturbed as grade increased, 3.269-fold risk when others suggested they choose a medical career rather than their own desire, and 7.557-fold risk for students with COVID-19 in their family, relatives, or friends; while the "disturbed-undisturbed" group showed that students with internship experience for professional attitudes strengthened was 2.933-fold than those without internship experience.

CONCLUSIONS

The professional attitudes of medical students have been strengthened during the COVID-19 pandemic. The results provide evidence of the importance of education on professional attitudes among medical students during public health emergencies.

Causes of burnout in nursing seniors: A mixed methods study

BACKGROUND

In recent years, the issue of burnout in newly graduated and student nurses has become an increasing interest of researchers. Burnout seriously affects the behavior, health, life and relationships of individuals.

OBJECTIVES

This research was conducted to investigate the causes of burnout in nursing senior students in depth.

DESIGN

This research, based on mixed method, was carried out with a sequential exploratory design.

PARTICIPANTS

The study was conducted with 148 nursing students in their last year at a university in the Marmara Region of Türkiye.

METHOD

Data were collected with Personal Information Form, The Burnout Measure Short Version (BMS) and Maslach Burnout Inventory-Student Form (MBI-SF) between March and April 2022. Qualitative interviews were conducted face-to-face with 16 students determined by criterion sampling method between May and June 2022. A semi-structured interview form was used to collect qualitative data. Descriptive statistics (number, percentage, mean, standard deviation) were used for the analysis of quantitative data. Thematic analysis was performed for qualitative data.

RESULTS

The mean BMS total score for the sample group was 4.50. MBI-SF sub-dimension mean scores; It is in the form of exhaustion (16.52), depersonalization (12.66) and competence (12.41). According to the scores of nursing senior students from BMS, it was determined that 22.3 % (n = 33) had burnout, 23 % (n = 34) had a serious burnout problem, and 28.4 % (n = 42) needed professional help as soon as possible. In addition, three main themes emerged as a result of the thematic analysis: (i) Effects of Burnout, (ii) Factors Affecting Burnout, (iii) Ways to Cope with Burnout.

CONCLUSION

It was determined that one of the five nursing students was in danger of burnout. The prevalence of burnout in nursing senior students was 73.7 %. Besides, it was determined that the problems experienced in the student's nursing education and professional practices, the pandemic process, financial concerns, family-related situations, not finding time for social activities, and future anxiety were the factors causing burnout.

A longitudinal study on depression and anxiety in college students during the first 106-days of the lengthy Argentinean quarantine for the COVID-19 pandemic

BACKGROUND

The Argentinean quarantine is among the strictest and longest quarantines in the world. To determine if a worsening pattern on mental health would emerge with a prolonged quarantine duration, a longitudinal analysis pertaining to the lengthy mandatory Argentinean quarantine was conducted.

AIM

To examine depression and anxiety changes in college students, as a function of quarantine duration, demographic and health-related factors, during successive time cuts of the lengthy mandatory quarantine in Argentina.

METHODS

We used a longitudinal design, N = 1492 college students. For the first measurement, successive samplings were carried out across quarantine sub-periods of up to 106-days duration. The follow-up was one month later.

RESULTS

Particularly women, young, and having a history of mental disorder and suicidal behavior, were more depressed and anxious under mandatory restrictive quarantine conditions. Repeated measures of both depression and anxiety scores remained constantly high during the more restrictive quarantine sub-periods of up to 13 and 53-days duration, and decreased during the less restrictive quarantine sub-period of up to 106-days duration, but with small effect sizes (0.10-0.08).

CONCLUSIONS

Restrictive quarantine has negative effects on mental health outcomes. Partial spontaneous remissions of depression and anxiety symptoms may be expected with further quarantine relaxations.

Factors associated with perceived stress and depressive symptoms among college students during the COVID-19 pandemic

The COVID-19 pandemic had detrimental effects on college students' psychosocial well-being due to campus closures starting in Spring 2020. This study examined changes in perceived stress and depressive symptoms before and during the pandemic using longitudinal data collected from students over the 2019-2020 academic year. We also compared data from this sample in Fall 2019 (N = 282) to data collected from another sample in Fall 2020 (N = 240). Latent change modeling showed increases in stress during Spring 2020. Additionally, the Fall 2020 sample had higher levels of stress than the Fall 2019 sample. Differences in stress and depressive symptoms did not depend on underrepresented minority (URM) status, income, gender, or membership in Greek life or other organizations. However, third- and fourth-year students and student-athletes experienced more stress during the pandemic. Findings suggest an adverse and differential impact of the pandemic on students' psychosocial well-being.

Psychological disturbances encountered by selected undergraduates studying at the University of Ruhuna, Sri Lanka during the Covid-19 pandemic: a cross-sectional study

University undergraduates are increasingly recognized as a vulnerable population with a higher level of psychological disturbances. During the Covid-19 pandemic, universities closed all over the world, resulting in the psychological well-being of this population being severely affected across the globe. This study examined the prevalence of stress, anxiety, and depressive symptoms encountered by undergraduates of the selected five faculties at the University of Ruhuna in Southern Sri Lanka due to the Covid-19 pandemic, its associated factors, and the correlations between stress, anxiety, and depressive symptoms. An online, cross-sectional, descriptive study was conducted among undergraduates using pre-tested, self-administered questionnaires from the randomly selected five faculties: Allied Health Sciences, Engineering, Humanities and Social Sciences, Management and Finance, and Medicine. Undergraduates were invited to complete the Google Form. Socio-demographic details and a 21-item Depression, Anxiety, and Stress Scale (21-DASS) were used for data collection. Stress, anxiety, and depressive symptoms were evaluated using a Sinhala version of the 21-DASS scale. Ethical permission was granted by the Ethics Review Committee of the Faculty of Allied Health Sciences, University of Ruhuna. Among the 359 undergraduates, the majority were represented by females (62.1%). The mean age of the sample was 23.67 years (SD ± 1.6). Stress, anxiety, and depressive symptoms were found to be prevalent in 53.7%, 41.8%, and 63.8% of undergraduates respectively. Younger and female undergraduates had more impact on psychological issues than their counterparts. It revealed a significant positive correlation between anxiety and depressive symptoms (r = 0.646, p < .001), anxiety and stress (r = 0.868, p < .001), and stress and anxiety (r = 0.786, p < .001). Most undergraduates experienced considerable levels of stress, anxiety, and depressive symptoms during the Covid-19 as increasing stress, anxiety, or depressive symptoms, tend to increase all types of psychological disturbances. The development of mental health among undergraduates is essential and needs innovative strategies to improve the psychological well-being of undergraduates. The initiation of a stress management programme and expanded available counseling services are also important. Further studies are needed to be conducted on the extended topic of how the Covid-19 era is affecting the psychological well-being of undergraduates from different universities (state/non-state), locations, and different study departments.

The effect of yoga classes on the mental health of female college students

BACKGROUND

Mental health problems have become prominent among college students. The purpose of this study was to to explore the influence of yoga course on female college students' mental health.

METHODS

Three hundred fifty-four female college students enrolled in Anhui University of Traditional Chinese Medicine in 2020 or 2021 were selected and divided into three groups according to whether they took PE courses and the content of PE courses: No physical education group (control group) (N.=131), aerobics group (N.=120), and yoga group (N.=103), questionnaire survey was conducted before, at the middle (8 weeks), and at the end of the course. The patient health questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Connor- Davidson resilience scale (CD-RISC) were used to evaluate the mental health status of female college students at different time points.

RESULTS

The demographic characteristics of the three groups showed no significant differences. Repeated measures Analysis of Variance showed that there were time main effect, group and time interaction effect and group main effect in patients' health questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Connor- Davidson resilience scale (CD-RISC) among the three groups before and after practice. Patient health score: The score of PHQ-9 and GAD-7 in yoga group at 16 weeks, at 8 weeks, before practice (P<0.05), and the scores of yoga group at 8 weeks and 16 weeks were lower than those of control group and aerobics group (P< 0.05). For CD-RISC: the score of yoga group at16 weeks, 8 weeks, before practice (P<0.05), and the scores at 8 and 16 weeks were higher than those of aerobics group and control group (P<0.05); There was no significant difference before and after exercise between the control group and the aerobics group (P< 0.05).

CONCLUSIONS

The teaching of yoga course can enhance the level of psychological resilience, improve depression and anxiety, promote mental health, and improve subjective well-being and improve the quality of college life.

Vaping Behavior in Young Adults During the COVID-19 Pandemic

BACKGROUND

Electronic nicotine delivery systems (ENDS) continue to be popular among young adults. These devices are often advertised as a healthy alternative to quitting tobacco cigarettes. However, young adults represent a population who view it as a novel behavior that provides a sense of popularity, social acceptance, and desired physiologic properties. The objective of this study was to examine characteristics of vaping behavior among college students and explore possible associations between groups of vaping behavior (stopped, initiated, increased, decreased, stayed the same).

METHODS

In a multi-center cross-sectional study, 656 students from University of Tampa in the United States and University of Applied Sciences in Germany (IST) were recruited to answer a 31-item online questionnaire. A chi-square test was used to evaluate associations between the groups.

RESULTS

Prevalence rates indicated approximately 31% of all students were currently using ENDS. Even though more negative than positive experiences with ENDS were reported, most students stated their vaping increased during COVID-19 lockdowns. Addiction and stress relief emerged to be predictors (P < .001) of an increase in vaping, whereas social motives were not statistically significant. Living situation (P = .63) and depression (P = .10) were not significantly associated with vaping behavior.

CONCLUSIONS

ENDS products continue to yield very high levels of nicotine creating addiction in young adults. Addiction counseling and evidenced-based practices should be employed at every level (individual, community, and school). Additionally, mental health counseling for students in pandemic and high-stress environments may help to combat stress in a more proactive manner than self-medicating.

Neuroimaging profiles of the negative affective network predict anxiety severity in patients with chronic insomnia disorder: A machine learning study

BACKGROUND

Sleep is instrumental in safeguarding emotional well-being. While the susceptibility to both insomnia and anxiety has been demonstrated to involve intricate brain systems, the neuroimaging profile of chronic insomnia disorder with comorbid anxiety symptoms (CID-A) remains unexplored. Employing machine learning methodologies, this study aims to elucidate the distinct neural substrates underlying CID-A and to investigate whether these cerebral markers can prognosticate anxiety symptoms in patients with insomnia.

METHODS

Functional magnetic resonance imaging (fMRI) data were procured from a relatively large cohort (dataset 1) comprised of 47 CID-A patients, 49 CID patients without anxiety (CID-NA), and 48 good sleeper controls (GSC). Aberrant cerebral functional alterations were assessed through functional connectivity strength (FCS) and resting-state functional connectivity (rsFC). Subsequently, Support Vector Regression (SVR) models were constructed to predict anxiety symptoms in CID patients based on neuroimaging features, which were validated utilizing an external cohort (dataset 2).

RESULTS

In comparison to CID-NA and GSC subjects, CID-A patients exhibited heightened FCS in the right dorsomedial prefrontal cortex (DMPFC), a central hub within the negative affective network. Moreover, the SVR models revealed that DMPFC-related rsFC/FCS features could be employed to predict anxiety symptoms in two independent cohorts of CID patients.

LIMITATION

Modifications in brain functionality might vary across insomnia subtypes.

CONCLUSION

The present findings suggest a potential negative affective network model for the neuropathophysiology of CID accompanied by anxiety. Importantly, the negative affective network pattern may serve as a predictor for anxiety symptoms in CID patients.

Knowledge and coping style about depression in medical students: A cross-sectional study in China

OBJECTIVES

The current study aimed at ascertaining the depression levels of medical students and their knowledge levels of depression, and exploring the relationship between the level of knowledge and coping styles of the medical students on depression.

METHODS

An online-based survey was developed in Changzhi Medical College. The questionnaire included demographic and socioeconomic data, questions about depression knowledge and copying styles of depression, and the Zung Self-Rating Depression Scale (SDS). A total of 1931 questionnaires were returned by respondents.

RESULTS

The medical students produced a mean SDS score of 44.29 (SD = 11.67). The prevalence of depression was 29.7%. Sophomore, female, and poor family relationships were parameters associated with a higher SDS score. The total correct rate for knowledge of depression was 64.14%. There were statistical differences between with depression students and non-depression students on the rate of the correct answers in the following questions:"Female has more probability", "Depression can be adjusted by oneself", "Associated with one's character", "Know cure method of depression", "Know drug use of depression", "Know depression influence for health", and "Know prevention method of depression". Depression students were more likely to have a lower rate of correct answer for above questions. Asking for help from psychological consultation was the primary coping mechanism among the medical students. The logistic regression analysis results found that depressed students who chose the coping way of no ways of coping were more likely to be females OR = 1.470 (1.078, 2.005), residents in rural area OR = 1.496 (1.038, 2.156), in poor family relationships OR = 2.428 (1.790, 3.293), and have lower cognitive level of depression knowledge OR = 1.920 (1.426, 3.226).

CONCLUSIONS

It is necessary to focus on mental health of medical students, especially in female, residents in rural area, in poor family relationships, and having lower cognitive level of depression knowledge. Medical students were insufficient on depression knowledge and coping styles, and efforts that train students know risk of impaired mental health could also improve diagnosis and treatment.

Negative psychological and educational impacts of Corona Virus Anxiety on Chinese university students: Exploring university students' perceptions

COVID-19 has greatly affected various aspects of societies worldwide, including the mental health and quality of education for students. Different studies investigated the consequences of the pandemic, but only a few studies have addressed the negative psychological and educational impacts of Corona Virus Anxiety (CVA). This study addresses the effects of CVA on Chinese students and explores university perceptions of its consequences. A mixed-methods research design was used, with 440 university students selected through convenience sampling. The researchers used the CVA scale, generalized anxiety scale, mental health questionnaire, and a self-report scale to assess the students' educational attainment. In addition, 14 students were interviewed for the qualitative phase of the study. Data from the quantitative phase were analyzed using Pearson correlation and descriptive statistics, while content analysis techniques were employed for analyzing the qualitative data. Results showed that CVA is negatively associated with students' anxiety, stress, and depression. Furthermore, stress, anxiety, depression, and CVA were found to be negatively associated with students' GPAs. Qualitative findings revealed that CVA negatively affected students' GPAs, research projects, classroom engagement, and graduations. The findings are theoretically and practically important to universities, schools, and educational centers to avoid the effects of the CVA on students' educational attainment and mental health through appropriate planning and providing facilities to the students during the lockdown.

Anxiety, depression, and stress prevalence among college students during the COVID-19 pandemic: A systematic review and meta-analysis

Background: Since the end of 2019, the coronavirus disease (COVID-19) outbreak rapidly became a pandemic. The psychological state of people during the COVID-19 pandemic has gained interest. Our aim was to study the prevalence of anxiety, depression, and stress in college students during the COVID-19 pandemic. Methods: A systematic search of Medline, Embase, Web of Science, and the Cochrane Library was conducted up to September 20, 2020. Reviewers independently assessed full-text articles according to predefined criteria. Stata14/SE was used to calculate the prevalence and 95% confidence intervals (CIs) of anxiety, depression, and stress among college students from different countries. A random effects model was adopted. The Egger test was used to determine publication bias. Results: A total of 280 references were retrieved, and 28 papers met our inclusion criteria, for a total of 436,799 college students. Thirteen studies involved non-Chinese college students, and 15 studies involved Chinese college students. The prevalence of anxiety, depression, and stress was 29% (95% CI, 19-25%), 37% (95% CI, 32-42%), and 23% (95% CI, 8-39%), respectively. Conclusion: The COVID-19 pandemic has had a negative psychological effect on college students, and the prevalence of anxiety, depression, and stress among Chinese college students is lower than among non-Chinese college students.

Psychological Health and Risk Factors of College Students within the Context of the COVID-19 Pandemic: A Cross-Sectional Study

BACKGROUND

Students are a priority population in mental health research. This study aimed to explore the risk factors of anxiety and depression symptoms among college students in Chongqing, a megacity under the impact of COVID-19, and to provide a basis for determining the priorities of public health policies and implementing effective educational health care interventions.

METHODS

In this cross-sectional study conducted in Chongqing, China, the data came from web-based stratified random sampling. Anxiety and depression symptoms were measured by the Self-Rating Anxiety Scale (SAS) and the Center for Epidemiological Studies Depression Scale (CES-D), respectively, and risk factors were analyzed by logistic regression.

RESULTS

Data were obtained from 915 college students (34.75% were male, and 65.25% were female) with age (20.29 ± 1.51) in Chongqing, China. The prevalence rates of anxiety and depression were 19.78% and 22.62%, respectively. Logistic regression analysis revealed that the risk factors of anxiety symptoms were associated with junior years, sleep time of less than 6 h a day, influence on career planning, and depression symptoms. Comprehensive, science and engineering, and medicine disciplines, having siblings, poorer mastery of study, and anxiety symptoms were risk factors for developing depression symptoms.

CONCLUSIONS

During the pandemic, college students experienced varying degrees of anxiety and depression. Our research findings highlight the necessity of universities and relevant departments providing precise mental health education for college students under major public health emergencies.

Exploring Sociodemographic Characteristics, Adverse Childhood Experience, and Mental Health History as Predictors of Anxiety and Depression among Adolescents and Young Adults: Findings from the MoreGoodDays Support Program in Alberta, Canada

BACKGROUND

The COVID-19 pandemic has increased psychological disorders among adolescents and young adults.

METHODS

This study used a cross-sectional design. An online survey questionnaire was used to collect sociodemographic and clinical information from subscribers of MoreGoodDays program, a daily supportive text message program co-designed with adolescents and young adults for their peers in Alberta. Validated instruments, the Generalized Anxiety Disorder GAD-7 scale and Patient Health Questionnaire-9 PHQ-9 were used to collect information on likely GAD and likely major depressive disorder (MDD). Data was analyzed with SPSS version 25 using chi-squared tests and binary logistic regression analysis.

RESULTS

343 subscribers of MoreGoodDays participated in the survey. Overall, 117 (56.0%) respondents had a likely MDD and 97 (46.6%) had a likely GAD. Participants who would like to receive mental health counselling were 27 times more likely to experience GAD (OR = 27; 95% CI: 3.09-250.00) and 40 times more likely to experience MDD (OR = 40.03; 95% CI: 4.43-361.51) than those who did not. Respondents who had received mental health counselling in the past were 18.5 times more likely to experience MDD compared with those who had not (OR = 18.52; 95% CI: 1.55-200.00). Demographic variables, including age, education, employment, and relationship status, and clinical variables, such as history of anxiety, depression, obsessive-compulsive disorder, ADHD, and adverse childhood experience, did not independently the predict presence of likely GAD or MDD in subscribers of MoreGoodDays.

CONCLUSION

The prevalence of anxiety and depression was relatively high among subscribers of MoreGoodDays, indicating the long-term effect of the COVID-19 pandemic. This finding has significant implications in the broader contextof mental health research and emphasizes the need for more research into innovative mental health support for this cohort. The desire to receive counselling was predictive of both anxiety and depression and is a positive sign of the openness of this cohort to receive psychological intervention. Since this group is mostly adapted to mobile text technology, government agencies and policymakers should prioritize and implement readily accessible interventions such as supportive text messages to support their psychological well-being.

Effects of COVID-19 stress, proximity, and adverse childhood experiences on healthcare workers' mental health

Past research has shown that healthcare workers (HCWs) experience high levels of psychological distress during epidemics and pandemics, resulting in cascading effects that have led to chronically understaffed hospitals and healthcare centers. Due to the nature of their responsibilities and workplace stress, HCWs are among vulnerable groups especially during global health crises. During COVID-19 many healthcare workers reported greater symptoms of anxiety, depression, and COVID-19 related worries. Furthermore, adverse childhood experiences increase vulnerability for psychological conditions, especially during pandemics. This study sets out to (1) investigate the moderating effects of adverse childhood experiences on healthcare workers' COVID-19 related stressors and depression/anxiety symptoms, and (2) investigate the moderating effects of adverse childhood experiences on proximity to the COVID-19 virus and depression/anxiety symptoms. Participants included 438 employed HCWs recruited from academic medical centers and smaller healthcare agencies in northcentral Florida between October to December 2020. Mean age of participants was 38.23 (SD = 11.5) with most of the HCWs being white (72.1%), non-Hispanic (86.8%) and female (82%). Healthcare workers completed several online questionnaires, including the Adverse Childhood Experiences scale, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, a COVID-19 specific worries scale, and a Social Proximity to COVID-19 scale. Healthcare workers experiencing specific COVID-19 worries reported experiencing anxiety and depressive symptoms. A significant positive interaction was seen between childhood adverse experiences globally and COVID-19 worries on anxiety symptoms. A significant positive interaction was observed between childhood maltreatment specifically and COVID-19 worries on depressive symptoms. Additionally, a positive interaction effect was seen between childhood adverse experiences and COVID-19 social proximity for both depression symptoms and anxiety symptoms. Findings from the present study indicate that adverse childhood experiences strengthen the relationship between COVID-19 worry/proximity and negative psychological symptoms. Vulnerable populations such as individuals who have experienced ACEs could benefit from targeted and specific interventions to cope with the collective trauma experienced globally due to COVID-19. As COVID-19 becomes endemic, hospital leadership and authorities should continue addressing COVID-19 worries and HCWs' psychological symptoms through mental health support and organizational interventions.

The effectiveness of a health education intervention to reduce anxiety in quarantined COVID-19 patients: a randomized controlled trial

INTRODUCTION

The COVID-19 pandemic is regarded as a serious public health concern that boosts levels of stress and anxiety which could be explained by several reasons, including social isolation. In this regard, we aimed to assess the impact of health education on the anxiety level of COVID-19 patients during the isolation period.

METHODS

This is a randomized controlled trial conducted between February 2021 and June 2021. Patients tested positive for Covid-19 with mild to moderate forms were randomized to Education (n = 267) or control (n = 269). The education group received a phone health education session on day 1 (D1) following the diagnosis. The three components of the health education intervention were an explanation of the coronavirus disease, what to do in the event of complications, and the recommended preventive measures. The two groups received a telephone evaluation of their Hospital Anxiety and Depression scores on D1 and day seven D7 following the positive diagnosis. The primary outcome was the rate of anxiety reduction in each group on D7 based on a HAD-A score ≥ 8. Secondary outcomes were the rate of anxiety reduction on D7 based on a HAD-A score ≥ 11, the percentage of people complying with isolation and the scores of adherences to preventive measures during the isolation in each group.

RESULTS

Hundred and ninety-six patients in the intervention group and 206 patients in the control group completed the study. The sociodemographic, clinical, and initial anxiety level features of the intervention and control groups were comparable at baseline (p ≥ 0.05). On D7, the education group's anxiety level (HAD-A ≥ 8) decreased from 26 to 16.3% (p = 0.013) while in the control group it increased from 19.4 to 22.8% (p = 0.37). Thus, the percentage change in anxiety between D1 and D7 (delta D7 - D1) was - 9.7% in the Education group and + 3.4% in the Control group. Using the HAD-A ≥ 11 thresholds, the percentage of anxiety decreased from 15.3 to 11.2% (p = 0.26) between D1 and D7, while it increased in the control group from 9.7 to 15.7% (p = 0.045). Thus, the education group's change in anxiety (delta D7 - D1) was - 4.1%, while the control group's change was + 6%.

CONCLUSION

During an outbreak, providing health education to quarantined patients may be beneficial to reduce the psychological impact of the disease.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov Identifier: NCT05715593, retrospectively registered on 8/02/2023 https://clinicaltrials.gov/ct2/results?term=NCT05715593&Search=Search .

The mediating role of psychological capital in the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Although life satisfaction is a predictor of depressive and anxiety symptoms, the mechanisms underlying this association are poorly understood. This study examined how psychological capital (PsyCap), a positive psychological state, mediated the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 583 students. Depressive symptoms, anxiety symptoms, life satisfaction, and PsyCap were measured anonymously. A hierarchical linear regression analysis was performed to explore the effects of life satisfaction on depressive and anxiety symptoms. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between life satisfaction and depressive and anxiety symptoms.

RESULTS

Life satisfaction was positively associated with PsyCap and its four components. There were significant negative associations between life satisfaction, psychological capital, resilience, optimism, and depressive and anxiety symptoms among medical students. Self-efficacy was negatively associated with depressive and anxiety symptoms. Psychological capital (a×b = -0.3201, BCa 95% CI: -0.3899, -0.2446; a×b = -0.2749, BCa 95% CI: -0.3817, -0.1996), resilience (a×b = -0.2103, BCa 95% CI: -0.2727, -0.1580; a×b = -0.1871, BCa 95% CI: -0.2520, -0.1414), optimism (a×b = -0.2100, BCa 95% CI: -0.3388, -0.1150; a×b = -0.1998, BCa 95% CI: -0.3307, -0.0980), and self-efficacy (a×b = -0.0916, BCa 95% CI: 0.0048, 0.11629; a×b = 0.1352, BCa 95% CI: 0.0336, 0.2117) significantly mediated the association between life satisfaction and depressive and anxiety symptoms.

LIMITATIONS

This was a cross-sectional study, and causal relationships between the variables could not be ascertained. Self-reported questionnaire instruments were used for data collection, which may have recall bias.

CONCLUSIONS

Life satisfaction and PsyCap can be used as positive resources to reduce depressive and anxiety symptoms among third-year Chinese medical students during the COVID-19 pandemic. Psychological capital and its components (self-efficacy, resilience, and optimism) partially mediated the relationship between life satisfaction and depressive symptoms, and completely mediated the relationship between life satisfaction and anxiety symptoms. Therefore, improving life satisfaction and investing in psychological capital (especially self-efficacy, resilience, and optimism) should be included in the prevention and treatment of depressive and anxiety symptoms among third-year Chinese medical students. Additional attention is needed to pay for self-efficacy in such disadvantageous contexts.

Effect of five-elements music therapy combined with Baduanjin qigong on patients with mild COVID-19

Background

To investigate the physical and psychological effects of five-element music therapy combined with Baduanjin qigong treatment on inpatients with mild coronavirus disease 2019 (COVID-19) in Wuhan.

Methods

A mixed-methods study was used. In the quantitative study, a randomized controlled trial was performed on 40 study participants divided into a control group (n = 20) and an intervention group (n = 20). The Self-rating Anxiety Scale, Self-rating Depression Scale and Pittsburgh Sleep Quality Index were compared. For qualitative analysis, it adopted purposive sampling method, 13 patients of different ages from 18 to 60 years old and different exercise behavior were selected as the participants from the intervention group. A semi-structured interview method was used to collect data, and the content analysis method was used for data analysis. An interview outline was developed to assess the psychological condition and personal functional-exercise behavior of patients.

Results

In the quantitative study, the anxiety self-scores and depression self-scores of patients in intervention group were significantly lower compared with control group after treatment (p < .05). The sleep quality of intervention group was significantly improved compared with control group (p < .001). Participants in the qualitative study responded to questions posed through semi-structured interviews. The effect of intervention was good, which has been supported and recognized by patients.

Conclusion

The treatment of five-element music therapy combined with Baduanjin qigong on patients with mild COVID-19 alleviated anxiety and depression, and improved sleep quality, which was beneficial to the patients' physical and psychological recovery.

Psychological problems and associated factors among high school students during COVID-19 pandemic in Sawla town, Gofa zone, southern Ethiopia

Background

Depression, anxiety, and stress (DAS) are common among high school students, and they have a negative impact on their academic performance and future lives. Pandemics, such as coronavirus disease 2019 (COVID-19), exacerbate these issues. Although psychological problems are studied in developed countries, they are overlooked in developing countries such as Ethiopia. Therefore, this study was aimed to assess the prevalence of psychological problems and associated factors among high school students during the COVID-19 pandemic in Sawla town, Gofa zone, southern Ethiopia.

Methods

A facility-based cross-sectional study was conducted among 663 randomly selected high school students from March 1 to 31, 2021. The data was collected using the depression, anxiety, and stress scale (DASS-21) questionnaire and analyzed using SPSS version 26.0. Bivariable and multivariable analyses were computed to identify factors associated with DAS. An adjusted odds ratio with 95% CI was used to see the strength of the association and statistical significance was declared at p-value <0.05.

Results

The overall prevalence of depression, anxiety, and stress were 52.1% [95% CI: 48.3, 55.98], 52.6% [95% CI: 48.8, 56.4], and 22.6% [95% CI: 19.4, 25], respectively. Being rural residence (AOR: 4.88, 95% CI: 3.02, 7.88), living in a prison house or with a husband (AOR: 5.94, 95% CI: 1.65, 21.3), having a lower academic level (AOR: 6.23, 95% CI: 3.42), having poor knowledge about COVID-19 (AOR: 1.75, 95% CI: 1.21, 2.53) and poor COVID-19 prevention practices (AOR: 1.74, 95% CI: 1.09, 2.79) were associated with depression. Similarly, being a rural resident (AOR: 3.73, 95% CI: 2.38, 5.84), being a lower academic level (AOR: 2.54, 95% CI: 1.50, 4.30), having poor knowledge about COVID-19 (AOR: 1.54, 95% CI: 1.08, 2.19), and poor COVID-19 prevention practices (AOR: 2.12, 95% CI: 1.36, 3.32) were associated with anxiety. Furthermore, stress was associated with rural residence (AOR: 2.24, 95% CI: 1.42, 3.53), lower academic level (AOR: 4.70, 95% CI: 2.12, 10.4), and poor knowledge of COVID-19 (AOR: 1.71, 95% CI: 1.13, 2.58).

Conclusions

Depression, anxiety, and stress were all prevalent among high school students in the area. Rural residence, lower academic level, and poor knowledge about COVID-19, as well as poor COVID-19 prevention practices, all increase the likelihood of DAS. As a result, school-based psychological counseling interventions, particularly during pandemics, are critical.

The prevalence of post-traumatic stress disorder in college students by continents and national income during the COVID-19 pandemic: a meta-analysis

Introduction

The present study aimed to provide a more accurate representation of post-traumatic stress disorder (PTSD) in college students during COVID-19 by performing meta-analyses by continents, national income, and study majors, and comparing the results with estimated pooled prevalence.

Methods

Based on the guideline of PRISMA, literature was searched in PubMed, Web of Science, and Embase. The prevalence of PTSD was estimated through a random model based on the different continents and levels of national income, as well as study majors, and compared with the pooled prevalence of PTSD among college students.

Results

Totally 381 articles were retrieved from electronic databases and 38 articles were included in the present meta-analysis. The results showed that the pooled prevalence of college students' PTSD was 25% (95% CI: 21-28%). Prevalence estimates of PTSD among college students were statistically significant (p < 0.00001) when stratified with geographical regions, income levels, and study majors. In comparison with the pooled prevalence of PTSD (25%), subgroups of Africa and Europe, lower-middle-income countries, and medical college students possessed higher prevalence estimates.

Discussion

The findings of the study showed that the prevalence of PTSD in college students worldwide during COVID-19 was relatively high and varied in different continents and countries with different income levels. Therefore, healthcare providers should pay attention to the psychologically healthy condition of college students during COVID-19.

Psychological impacts of the COVID-19 pandemic in a Hispanic sample: Testing the buffering role of resilience and perceived social support

The current study examined the effects of specific COVID-19 stressors (i.e., family member's death due to COVID-19, COVID-19 infection, and school/financial stressors) on stress, anxiety, and depression and the potential buffering roles of resilience and perceived social support in the association between COVID-19 stressors and psychological symptoms in a Hispanic university student sample (n = 664). Participants were classified in three stressor groups: those reporting a family member's death due to COVID-19 (15.7%), those reporting their own or a family member's COVID-19 infection but no COVID-19 death (35.5%), and those reporting only school and/or financial stressors due to the pandemic (48.8%). Participants completed self-report measures online. Over 50% of participants with a COVID-19 death or infection in the family reported clinical levels of depression symptoms and over 40% endorsed clinically elevated anxiety symptoms. A series of moderation analyses with multi-categorical predictors found that among relatively highly resilient people, the magnitudes of the impact of COVID-19 infection or death on stress, anxiety, and depression were similar to the effect of a financial/school stressor alone, suggesting the buffering role of resilience. Perceived social support did not play a buffering role in the associations. Family member death due to COVID-19 and COVID-19 infection had significant negative psychological impacts on Hispanic young adults. Internal personal resources such as resilience, rather than external personal resources such as perceived social support, appear to be a critical factor that may help protect Hispanic individuals' mental health from the worst stressors of the COVID-19 pandemic.

Sleep disturbances and depression are bidirectionally associated among college student athletes across COVID-19 pandemic exposure classes

College athletes may be vulnerable to sleep disturbances and depression during the COVID-19 pandemic as a result of large shifts in social and athletic obligations. In a national sample of college athletes, we examined the associations between sleep disturbances and depression across two timepoints, using COVID-19 exposure as a moderator. Data were collected from 2098 NCAA Division I, II, and III college athletes during two timepoints, from April 10 to May 23, and from August 4 to September 15, 2020. First, a latent class analysis was conducted with five indicators of levels of COVID-19 exposure to determine different exposure profiles. Second, to examine the directionality of associations between sleep disturbance and depression, a cross-lagged panel model was added to the latent class membership structural equation model; this allowed for testing of moderation by COVID exposure class membership. Four highly homogeneous, well-separated classes of COVID-19 exposure were enumerated: Low Exposure (57%); Quarantine Only (21%); High Other, Low Self Exposure (14%); and High Exposure (8%). COVID-19 exposure class membership did not significantly moderate associations between sleep disturbances and depression. However, student athletes significantly differed in T2 depression by their COVID-19 exposure class membership. Depression and sleep disturbances were positively correlated at both timepoints (r _T1 = 0.39; r _T2 = 0.30). Additionally, cross-lagged associations were found such that T2 depression was associated with T1 sleep disturbances (β = 0.14) and vice versa (β = 0.11). These cross-lagged associations were not significantly affected by athletes' level of COVID-19 exposure during the beginning of the pandemic.

Depression and opinion of dental students regarding the hybrid learning model during the COVID-19 pandemic

BACKGROUND

The global spread of COVID-19 forced schools at all educational levels to close, which was repeated in more than 60 countries. In addition, the COVID-19 pandemic has affected the mental health of dental students world wide. This study hypothesizes that the prevalence of depression in dental students from El Salvador is higher than that reported in studies from Europe, Asia, and North America.

METHODS

This study was an online cross-sectional survey performed at the Faculty of Dentistry of the University of Salvador. The PHQ-9 questionnaire was applied to know the level of depression of the students, and a questionnaire focused on learning the opinion of the students on the hybrid teaching model adopted. Approximately 450 students participated in both questionnaires.

RESULTS

Regarding the levels of depression present in the students, 14% had minimal depression, 29% had medium depression, 23% had moderate depression and, 34% had severe depression. The students had an excellent opinion regarding the hybrid learning model.

CONCLUSIONS

The prevalence of depression in dental students in El Salvador seems to be higher than that reported in studies in non-Latin American countries. Therefore, universities must generate care plans for mental health to avoid these harmful effects on students during future contingencies.

Impact of family functioning on mental health problems of college students in China during COVID-19 pandemic and moderating role of coping style: a longitudinal study

BACKGROUND

During the COVID-19 pandemic, college students were required to stay at home and maintain social distance for the entire spring semester of 2020. There is little research on how family functioning influenced mental health problems and how coping styles moderated the relationship between family functioning and mental health problems among college students during their stay-at-home period.

METHODS

A total of 13,462 college students (age = 16-29 years) completed four online surveys between February and October 2020, namely the outbreak phase, remission phase, online study phase, and school reopening phase in Guangdong Province, China. Family functioning was assessed by the Family APGAR; coping styles were assessed by the Simplified Coping Style Questionnaire (SCSQ), depression symptoms and anxiety symptoms were evaluated by the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7) respectively. Generalized estimating equations were used to assess associations between variables, the logit link function was used to estimate the odds ratio of different subgroups, the Newton-Raphson method was used to estimate parameters, and the Wald test was used to test the main effect and the interaction effect.

RESULTS

The incidence rates of depression increased during the stay-at-home period from 33.87%, 95% CI (29.88%, 38.10%) to 40.08% 95% CI (35.76%, 44.55%) after schools reopened, χ² = 193.68, p < 0.001. The incidence rates of anxiety increased from 17.45%, 95% CI (14.59%, 20.73%) to 26.53%, 95% CI (16.94%, 23.67%) over the entire period, χ² = 195.74, p < 0.001. The percentages of students with highly functional, moderately dysfunctional and severely dysfunctional family functioning were 48.23%, 43.91 and 7.86% at T1 and 46.20%, 45.28%, and 8.52 at T4, respectively. The percentage of subjects with active coping style was 23.9%, negative coping style was 17.4%, strong response coping was 26.9%, and weak response coping was 31.7%. The incidence rate of depression and anxiety for different family functioning groups varied at different time points, and the interaction effect was significant (χ2 = 52.97, p < 0.001 and χ2 = 51.25, p < 0.001, respectively). The incidence rate of depression and anxiety for different family functioning groups with different coping styles also varied at different time points, the interaction effect was likewise significant (χ2 = 862.09, p < 0.001 and χ2 = 583.29, p < 0.001, respectively).

CONCLUSIONS

Having a severely dysfunctional family and a negative coping style increase the incidence rates of depression and anxiety. These findings highlight the importance of paying special attention to college students' family functioning and promoting appropriate coping strategies during and after COVID-19.

A systematic review and meta-analysis of studies exploring prevalence of non-specific anxiety in undergraduate university students

BACKGROUND

Anxiety is a common mental health problem in the general population, and is associated with functional impairment and negative impacts upon quality of life. There has been increased concern about university students' mental health in recent years, with a wide range of non-specific anxiety rates reported worldwide in undergraduate university students. We aimed to explore prevalence of non-specific anxiety in undergraduate university student populations.

METHODS

Four databases were searched to identify studies published between 1980 and 2020 which investigated prevalence of non-specific anxiety in undergraduate university students. Each study's quality was appraised using a checklist. Sub-analyses were undertaken reflecting outcome measure utilized, course of study, location of study, and whether study was before or during the COVID-19 pandemic.

RESULTS

A total of 89 studies - representing approx. 130,090 students-met inclusion criteria. Eighty-three were included in meta-analysis, calculating a weighted mean prevalence of 39.65% (95% CI: 35.72%-43.58%) for non-specific anxiety. Prevalence from diagnostic interview studies ranged from 0.3%-20.8% 12-month prevalence. Prevalence varied by outcome measure used to assess non-specific anxiety, the type of course studied by sample, and by study location. In half the studies, being female was associated with being more likely to have higher non-specific anxiety scores and/or screening above thresholds. Few of the included studies met all quality appraisal criteria.

CONCLUSION

The results suggest that approximately a third of undergraduate students are experiencing elevated levels of non-specific anxiety. Results from sub-analyses have identified some methodological issues that need consideration in appraising prevalence in this population.

Negative Affect Regulation and Marijuana Use in College Students: Evaluating the Mediating Roles of Coping and Sleep Motives

Negative affect regulation models suggest that marijuana may be used to reduce negative affect. Extant research has provided support for these models, indicating that specific motives for marijuana use, particularly coping motives (i.e., using to alleviate negative affects), mediate relations between affective vulnerabilities and marijuana outcomes. However, sleep motives (i.e., using to promote sleep) have been neglected from such models, despite their theoretical relevance. The present study tested two multiple mediation models in a large sample of marijuana-using college students (N = 1,453) to evaluate the indirect effects of coping and sleep motives in paths from depressive and anxiety symptoms to marijuana outcomes (use, consequences, and cannabis use disorder [CUD] symptoms). Both coping and sleep motives mediated the effects of depressive/anxiety symptoms on each marijuana variable. Moreover, significant double mediated effects were found, such that higher affective symptoms were associated with greater motives; which were associated with more marijuana use; which was related to more negative consequences and CUD symptoms. The findings provide support for sleep motives as a relevant pathway between affective vulnerabilities and marijuana outcomes. Additional research is needed to evaluate the potential benefits of interventions targeting specific marijuana motives.

Loneliness, affective disorders, suicidal ideation, and the use of psychoactive substances in a sample of adolescents during the COVID-19 pandemic: A cross-sectional study

PROBLEM

The global coronavirus (COVID-19) pandemic has been challenging for adolescents. Indeed, with the closure of schools and social centers and reduction of extracurricular activities, increased social isolation has compounded difficulties in and with school performance, loneliness, and social networking. Increased risk of mental health problems, substance abuse, affective disorders, suicidal ideation, and suicide has been reported in adolescents.

METHODS

This cross-sectional study assesses the association between loneliness, depression, anxiety, suicidal ideation, the use of social networks, and school achievement in a sample of Italian adolescents during the COVID-19 pandemic. This study also explores emotional dysregulation through the association between affective disorders (depression and anxiety), substance use, and social networks. The sample comprises adolescents in the first and second grades of high school during the pandemic; participants received an email explaining the purpose of the e-research. Data were collected using the Strengths and Difficulties Questionnaire, the Achenbach System of Empirically Based Assessment, and the Loneliness Scale.

FINDINGS

A total of 505 adolescents completed the web survey. Data revealed that students experienced difficulties with loneliness, problems with school achievement, and extracurricular activities. The mean scores for depression and anxiety were close to the borderline range. A total of 14.3% of adolescents intentionally harmed themselves or attempted suicide.

CONCLUSIONS

This study raises concerns about the impacts of the pandemic on adolescents that require the attention of adult reference figures who deal with adolescents, such as parents, teachers, and healthcare professionals. Results indicate the necessity of providing early interventions aimed at the prevention of psychopathologies and the promotion of adolescent mental health due to the pandemic.

The importance of high quality real-life social interactions during the COVID-19 pandemic

The coronavirus pandemic has brought about dramatic restrictions to real-life social interactions and a shift towards more online social encounters. Positive social interactions have been highlighted as an important protective factor, with previous studies suggesting an involvement of the amygdala in the relationship between social embeddedness and well-being. The present study investigated the effect of the quality of real-life and online social interactions on mood, and explored whether this association is affected by an individual's amygdala activity. Sixty-two participants of a longitudinal study took part in a one-week ecological momentary assessment (EMA) during the first lockdown, reporting their momentary well-being and their engagement in real-life and online social interactions eight times per day (N ~ 3000 observations). Amygdala activity was assessed before the pandemic during an emotion-processing task. Mixed models were calculated to estimate the association between social interactions and well-being, including two-way interactions to test for the moderating effect of amygdala activity. We found a positive relationship between real-life interactions and momentary well-being. In contrast, online interactions had no effect on well-being. Moreover, positive real-life social interactions augmented this social affective benefit, especially in individuals with higher amygdala being more sensitive to the interaction quality. Our findings demonstrate a mood-lifting effect of positive real-life social interactions during the pandemic, which was dependent on amygdala activity before the pandemic. As no corresponding effect was found between online social interactions and well-being, it can be concluded that increased online social interactions may not compensate for the absence of real-life social interactions.

The Mediating Effect of General Self-Efficacy Between Occupational Stress and Negative Emotion Among Psychiatric Nurses

The current study investigated occupational stress, anxiety, and depression among psychiatric nurses and explored the intermediary role of general self-efficacy between occupational stress, anxiety, and depression. In November 2020, 171 psychiatric nurses completed a self-report questionnaire. Spearman's correlation analysis was used to determine the relationship between the four variables and the bootstrap method was used to test the intermediary hypothesis. Results showed that 35.1% of psychiatric nurses had health risk stress. Among participants, detection rates of anxiety and depression were 24% and 46.8%, respectively. There was a positive correlation between occupational stress and anxiety (r = 0.577, p < 0.05) and depression (r = 0.653, p < 0.05). There was a negative correlation between general self-efficacy and anxiety (r = -0.358, p < 0.05) and depression (r = -0.500, p < 0.05), and general self-efficacy had a significant mediating effect between occupational stress and depression. However, the mediating effect of general self-efficacy on anxiety was not significant. Nurse managers should be aware of the importance of nurses' general self-efficacy and self-confidence. [Journal of Psychosocial Nursing and Mental Health Services, 61(3), 33-39.].

Psychological burden in Portuguese university students during the COVID-19 pandemic

Background

University students are a risk population for mental health problems. This study aims to evaluate the psychological burden of the COVID-19 pandemic in Portuguese university students and to uncover factors associated with worse psychological indicators.

Methods

We used an online survey to perform a cross-sectional study that evaluated students' perceptions, lifestyle, and psychological well-being during the pandemic. Depression symptoms and risk were measured by the Patient Health Questionnaire-9, and resilience levels were quantified by the 9-item Resilience Evaluation Scale. Self-perceived levels of anxiety and current mental health status were evaluated.

Results

From a population of around 30,000 students invited to participate, 1751 responses were obtained and 1447 were included. Most students were female (72.3%) and were taking a master's degree (58.4%). The course with more responses was engineering (25.5%), followed by medicine (13.2%). The prevalence rates for higher anxiety levels, depression risk, and low resilience levels were 66.7%, 37.3%, and 24.9%, respectively. The factors associated with better psychological outcomes were being male, spending more time studying, having a job, performing extracurricular activities, physical exercise, and relaxing activities. By contrast, spending more time watching news, difficulty accessing online lectures, and absence of contact with family or friends were associated with worse psychological indicators. Although all courses presented substantial levels of depressive symptoms, architectures/arts, sciences, and humanities scored significantly more in the depression scale. Medicine students had significantly higher resilience levels compared with other courses.

Conclusions

Our findings identify factors associated with worse psychological outcomes and can be used to create protective measures for the mental health of university students during current and future pandemics.

COVID-19 Stressors and Aggression among Chinese College Students: The Mediation Role of Coping Strategies

Although college students experienced excessive stressors (COVID-19 disease and negative COVID-19 news) during the COVID-19 pandemic, few studies have been aimed at coping strategies used by college students to deal with stress caused by the pandemic. Coping strategies are efforts to deal with anxiety in the face of a perceived threat or stress. Aggression is harmful social interaction with the intention of inflicting damage or harm upon another individual. In the present study, we aimed to examine the direct effect of stressors resulting from the pandemic on college students' aggression, as well as the indirect effect via their coping strategies. Through a cross-sectional survey of 601 Chinese college students (M-age = 20.28), we tested the proposed framework. We first found that information stressors of COVID-19 ranked highest among the four stressors of the pandemic. Results also indicated that college students' stressors of COVID-19 were directly and positively associated with their aggressive behavior. For the indirect effect, college students would adopt both adaptive coping strategies (self-help strategy) and maladaptive coping strategies (avoidance strategy and self-punishment strategy) with the stressors of COVID-19. Furthermore, adaptive coping strategy (approach strategy) was negatively related to their aggression, whereas maladaptive coping strategy (avoidance strategy and self-punishment strategy) was positively related to their aggressive behavior. The present research extends the general strain theory in the COVID-19 context. Practical implications are also discussed.

From study abroad to study at home: Spontaneous neuronal activity predicts depressive symptoms in overseas students during the COVID-19 pandemic

The objective of this study was to evaluate symptoms of depression and anxiety as well as changes in spontaneous neuronal activity in college students studying abroad during the coronavirus 2019 (COVID-19) pandemic. We examined functional brain changes using resting-state functional magnetic resonance imaging (fMRI), the amplitude of low-frequency fluctuations (ALFF), and regional homogeneity (ReHo) in overseas students with enforced isolation due to the COVID-19 pandemic. Additionally, emotional assessments were administered to determine the severity of depression and anxiety. The questionnaire results showed that anxiety and depressive symptoms differed between overseas students (i.e., those attending an overseas college virtually) and local students (i.e., those attending a local college in person). The fMRI data revealed higher ALFF values in the bilateral superior medial frontal gyrus, bilateral pre-central gyrus, left insula, and left superior temporal gyrus as well as lower ALFF values in the bilateral paracentral lobule (supplementary motor area) in overseas students. Moreover, ReHo analysis also revealed significant differences between overseas students and local students. Compared with local students, overseas students showed significantly increased ReHo in the right inferior frontal and superior temporal gyri and decreased ReHo in the bilateral paracentral lobule, bilateral superior medial frontal gyrus (supplementary motor area), and bilateral pre-central gyrus. In addition, in overseas students, altered ReHo in the cluster including the left superior and medial frontal gyri, pre-central gyrus, and paracentral lobule was significantly positively correlated with Self-Rating Depression Scale scores. Thus, spontaneous brain activity in overseas students changed during the COVID-19 pandemic. This change in brain function might be related to depression and anxiety symptoms. These results suggest that mental health services are needed to decrease the risk of anxiety and depression among college students studying abroad during the COVID-19 pandemic.

Mechanism of online emotional support accompany group for stress: The role of social support

Objective

To investigate the effect of social support on stress, and to clarify the effect and mechanism of Online Emotional Support Accompany Group (OESAG).

Methods

The group members who signed up for the public welfare project "Psychological Rehabilitation Group Psychological Service under the COVID-19 Pandemic" were divided into the treatment group, the control group, and the blank group with 37 members each. The treatment group received OESAG intervention, the control group received online time management group intervention, and the blank group was the waiting group. The three groups of subjects were synchronously tested before and after the intervention group.

Results

After the OESAG intervention, compared with the control group and the blank group, the treatment group showed that perceived social support was improved, and loneliness and stress were decreased.

Conclusion

Improving social support can effectively reduce stress. OESAG can effectively improve social support and so too decrease stress. This study could help in designing effective psychological intervention measures to reduce the degree of stress symptoms and enhance both personal and social levels of coping with stressful events.

Resilience, Perceived Stress from Adapted Medical Education Related to Depression among Medical Students during the COVID-19 Pandemic

The COVID-19 pandemic disrupted several routine teaching methods in clinical settings which causing psychological distress among medical students. This study aims to explore the association of perceived stress related to the adapted medical education, resilience, and depression among medical students at a medical school in northern Thailand during the COVID-19 outbreak. A total of 437 medical students were recruited in January 2022. Data were obtained using self-administered online questionnaires, including demographic data, perceived challenges in learning online classes, the Resilience Inventory (RI-9), and the Patient Health Questionnaire 9 (PHQ-9). Binary logistic regression analysis was employed to explore factors associated with depression (PHQ-9 ≥ 9). A total of 27% of the participants were identified as having depression. Logistic regression revealed that the presence of previous psychiatric conditions (ß = 2.80, p < 0.05), stress from lack of in-person contact with peers (ß = 1.48, p < 0.05), stress from lack of in-person communication with teachers (ß = 1.49, p < 0.05), and level of resilience (ß = 0.88, p < 0.001) were independently associated factors for depression among medical students. Level of resilience was negatively correlated with depressive symptoms (r = −0.436, p < 0.001). The rate of depression among medical students was higher during the pandemic. Resilience was associated with depression. Strengthening resilience might have an important implication for depression among medical students.

Mental health status among non-medical college students returning to school during the COVID-19 pandemic in Zhanjiang city: A cross-sectional study

The coronavirus disease-2019 (COVID-19) pandemic has brought huge and continuous damage to mental health. The mental health of non-medical college students after returning to school remains largely unknown and the influencing factors were awaited to be deciphered. This cross-sectional study was launched among 1,083 non-medical students in Zhanjiang city by means of online survey (WeChat App) from August 1st, 2022 to August 7th, 2022. Knowledge about COVID-19 and attitude toward COVID-19 were assessed by using 7-items and 5-items questionnaires, respectively. Sleep quality, anxiety and depression symptoms were evaluated by Pittsburgh sleep quality index (PSQI), Hamilton depression rating scale-17 (HDRS-17) and self-rating anxiety scale (SAS), respectively. The results showed that more than half of the participants were knowledgeable about COVID-19. The majority of the participants held positive attitude toward COVID-19. The data demonstrated that 6.8% students had poor sleep quality, and 1.86, 0.37 and 0.37% students had mild, moderate and severe anxiety, respectively. About 26.7, 4.7 and 1.7% students had minimal, mild-moderate and severe depression. Female students showed higher proportions of anxiety (p = 0.02) and depression (p < 0.0001) than male students. Students with monthly household income below 3,000 RMB were more vulnerable to anxiety (p = 0.017) and depression (p = 0.004). Correlation analysis and Multivariate logistic regression analysis results showed that lower grade was positively related with anxiety and depression. Female students, income lower than 3,000 RMB/month, poor knowledge about COVID-19 and negative attitude toward COVID-19 were associated with insomnia, anxiety and depression. This study indicated that during the COVID-19 pandemic, a majority of non-medical students returning to school remained good sleep quality and a small number of students suffered from depression and anxiety. To our knowledge, this is a novel study revealing the mental health of non-medical college students concerning COVID-19 in Zhanjiang.

Leveraging Campus Landscapes for Public Health: A Pilot Study to Understand the Psychological Effects of Urban Sheep Grazing on College Campuses

Since the 1980s, college students in the U.S. have self-reported a decline in their physical and emotional health. With these conditions compounded by the COVID-19 pandemic and its physical distancing restrictions, higher education institutions have an increased responsibility to establish strategic interventions and health-promoting programs for their students. Research collaborations between public health professionals and environmental designers have highlighted the benefits of environmental factors, such as wildlife, street trees, and public parks, on mental health. This pilot project aims to build upon the transdisciplinary dialogue between ecology, design, and public health by examining the social benefits of grazing lawnscape management, which is the practice of using herbivorous livestock to manage turfgrass areas. Through the design of an accessible central campus grazing space for a flock of 25 sheep and use of online questionnaires, a smartphone-based single-item survey, and open-ended feedback given via social media, the UC Davis Sheepmower Project addresses three primary questions: (1) Are there differences in self-reported stress levels and well-being between people who did not watch grazing sheep (no sheepmower group) compared with those who did watch grazing sheep (sheepmower group)? (2) Does holding sheep grazing events create opportunities for education about well-being and engagement with the campus community? (3) Can this type of urban grazing installation ultimately contribute to the overall identity of a college campus? Web-based questionnaire results indicate there is no significant difference in self-reported stress levels between the two groups; however, the moment-in-time smartphone-based single item question suggests that the presence of sheep provides temporary, noticeable relief and enhanced mood for those who observe the animals. Reflections posted on social media suggested that participants found the sheep grazing events fostered feelings of community and placemaking within the campus identity. However, the questionnaire sample indicated the grazing events did not have a significant effect on participants' sense of place or overall campus identity. This transdisciplinary effort breaks down traditionally siloed approaches to human and environmental health and is an example of a whole-systems approach to developing innovative solutions and encouraging applied collective action.

Effects of a peer health coaching program on college student lifestyle behaviors

Objective: Health coaching (HC) may promote healthy behaviors in incoming college students. Participants: 187 undergraduate students (76% female; age 18.6 ± 1.6) were recruited to participate in a peer HC program. Methods: Participants received four HC sessions in eight-weeks to work toward self-selected goals of physical activity (PA), diet, or stress management. PA was assessed using the International Physical Activity Questionnaire Short-Form, diet with the Eating Habits Confidence Survey, and stress with the Perceived Stress Scale. Results: Repeated measures ANOVAs investigated lifestyle behavior changes in 130 participants. Significant effects of time were reported, with a 39.6% gain in PA, 9.9% increase in dietary habit, and 16.3% decline in stress levels with moderate to large effect sizes (ηp2: 0.07-0.17; p< 0.01). Conclusion: The peer HC model promoted healthy lifestyles in college students. Additional research is needed to understand the effects of HC specifically for each goal, and student reactions to peer-led HC.