Psychological stresses among Chinese university students during the COVID-19 epidemic: The effect of early life adversity on emotional distress

Risk perception, compliance with COVID-19 measures, and the role of social media after China's lockdown lift

Introduction

Few studies have investigated people's reactions after a sudden lift. The transitional experiences of Chinese people at the end of 2022 serve as a valuable reference for pandemic management. Therefore, this study investigates Chinese people's perception of risks after the lifting, the influence of risk perception on their compliance with COVID-19 measures, and the moderating effect of social media on this influence.

Methods

Initially, using a random sampling approach, we carried out an online questionnaire survey through Questionnaire Star, an online questionnaire platform. 417 (304 females, 13-64 years old) participants responded to questions on their perception of risks, compliance with COVID-19 measures, and trust in social media. Then, in the follow-up experiment, we observed another 60 (30 females, 18-22 years old) participants' actual behaviors to see how they comply with COVID-19 measures (for the peak of the confirmed cases, we chose to make do with this small size). We also asked them to complete a paper questionnaire on risk perception and trust in social media.

Results

The initial survey indicated that, after the lifting, Chinese citizens perceived high risks (they reported a possibility of 61.04 out of 100 to be infected and threatened by COVID-19. The number was 54 in a previous study), showed a low degree of adherence to COVID-19 measures (on a scale of 1-5, they reported a score of 2.04 in private, and 1.89 in public), and social media positively moderated the relationship between risk perception and adherence (ΔR2 = 0.10, p < .01 for private behavior; ΔR2 = 0.13, p < .01 for public behavior). The follow-up experiment further confirmed these findings.

Conclusion

This study suggests that, when lifting lockdowns on a national scale, the government should inform the public about the risks accurately, encourage healthy behaviors, and make full use of social media to promote adherence to COVID-19 measures. By using a hybrid approach that combines a questionnaire survey with actual behavior observation, this study expands earlier research into the understudied context of lockdown lifts. Finding effective strategies to support individuals through the transition period can facilitate global pandemic management.

Adverse childhood experiences, traumatic events, and mental health among adults at two outpatient psychiatric facilities in Johannesburg, South Africa: a cross-sectional analysis

BACKGROUND

Adverse childhood experiences and adult trauma, including sexual abuse, physical abuse, neglect, and interpersonal violence, are highly prevalent in low-resource settings and associated with adverse psychological outcomes. However, there is limited focus on the impact of ACEs and trauma on mental health in sub-Saharan Africa. Therefore, this study examines the impact of traumatic events and ACEs on depression, anxiety, and stress scores among outpatients receiving psychiatric care at two public mental health treatment facilities in Johannesburg, South Africa.

METHODS

A sample of 309 participants were recruited between January and June 2022 at Helen Joseph Hospital and Alexandra 18th Avenue Clinic. Participants completed screening measures for mental health outcomes, including the 9-item Patient Health Questionnaire (PHQ-9), the 7-item General Anxiety Disorder scale (GAD-7) and the 10-item Perceived Stress Scale. We fitted modified Poisson and linear regression models to estimate the impact of ACEs and adult experiences of trauma on depression, anxiety, and stress scale scores.

RESULTS

47.57% (n = 147) of participants screened positive for anxiety, 44.66% (n = 138) for depression, and 17% (n = 54) for severe stress. More females screened positive for anxiety (65.31%), depression (65.94%), and stress (77.78%). Each ACE was associated with a 12% increased risk of depression, a 10% increased risk of anxiety, and a 17% increased risk of stress. In separately estimated models, each additional traumatic event during adulthood was associated with a 16% increased risk for depression, an 8% increased risk of anxiety, and a 26% increased risk of stress. Across all models, being male and self-reported physical health were consistently associated with a reduced risk for depression, anxiety, and stress.

CONCLUSIONS

ACEs and experiences of traumatic events as adults were associated with significantly increased risks of anxiety, depression, and severe stress. Given high exposure to ACEs and trauma and the associated impact on the mental health of individuals, families, and communities, there is a need to strengthen and scale innovative combination interventions that address multiple stressors impacting people in low-resource settings.

Psychological factors associated with COVID-19 related anxiety and depression in young adults during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic and the corresponding lockdown have drastically changed our lives and led to high psychological distress and mental health problems. This study examined whether psychological factors such as loneliness, perfectionism, and health anxiety are associated with COVID-19 related anxiety and depression during the pandemic in young Korean adults, after controlling for various socio-demographic factors and early life stress.

METHODS

A total of 189 participants (58.2% women) completed a cross-sectional online survey including the Fear of COVID-19 Scale, Center for Epidemiologic Studies Depression Scale, 3-item Revised UCLA Loneliness Scale, Frost Multidimensional Perfectionism Scale, and Whiteley Index-6. Hierarchical linear regression analyses with three blocks were employed to identify the factors that contributed to COVID-19 related anxiety and depressive symptoms.

RESULTS

Hierarchical regression analyses showed that higher health anxiety was significantly associated with more severe COVID-19 related anxiety (standardized regression coefficient, β = 0.599, p < 0.001). Additionally, higher levels of loneliness (β = 0.482, p < 0.001), perfectionism (β = 0.124, p = 0.035), and health anxiety (β = 0.228, p < 0.001) were significantly associated with higher depression scores. The three psychological factors explained 32.8% of the total variance in depressive symptom scores, after taking all covariates into account.

CONCLUSION

The results showed that health anxiety was a risk factor for both COVID-19 related anxiety and depression in young adults. Loneliness was the strongest predictor of depressive symptoms during the COVID-19 pandemic. These findings highlight the importance of identifying vulnerable individuals and encouraging psychological counselling and social connections to reduce the burden of psychiatric disorders during the pandemic.

Long-term effects of early adversity on the mental health of college students: The mitigating effect of physical exercise

Background

We aim to investigate the long-term effects of early adversity on university students' mental health and the mitigating role of physical exercise on this effect.

Methods

The survey sample consisted of 895 college students. Descriptive statistics, linear regression, and moderating effect analysis were used to analyze the results.

Results

(1) Early adversity negatively predict mental health level (β = -0.109, t = -4.981, p < 0.01); (2) Physical exercise can effectively mitigate the long-term harm of early adversity to mental health (β = 0.039, t = 2.001, p < 0.05); compared to low-level physical exercise (b simple = -0. 067, t = -7.88, p < 0.01), high-level physical exercise can mitigate the long-term harm of early adversity to mental health (b simple = -0, 025, t = -2. 37, p < 0.01).

Conclusion

Early adversity affects the mental health of university students, but physical exercise can effectively mitigate this effect.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

Exploration of college teachers' psychological adaptation to online teaching during the COVID-19 pandemic using potential profile analysis

The present study used a person-centered approach to examine college teachers' psychological adaptation to online teaching and its relationship with demographic variables. A total of 2104 college teachers were surveyed using the Psychological Adaption to Online Teaching Scale between March 25 and March 31, 2020. Data were analyzed using latent profile analysis, chi-square test, and multinomial logistic regression analysis. Based on their psychological adaptation during online teaching immediately after the coronavirus disease 2019 (COVID-19) outbreak, college teachers were divided into three latent profiles: common, maladaptive, and positive. Among these, the common type accounted for the largest proportion (56.1%), while the maladaptive type accounted for the smallest (10.9%). There were significant differences in the distribution of psychological adaptation latent types in college teachers with different educational backgrounds and professional titles. A better educational background and higher professional title is closely related with college teachers' psychological adaptation to online teaching.

Association of Major Disease Outbreaks With Adolescent and Youth Mental Health in Low- and Middle-Income Countries: A Systematic Scoping Review

IMPORTANCE

Adolescents and young people have been historically understudied populations, and previous studies indicate that during epidemics, these populations, especially in low- and middle-income countries (LMICs), are at high risk of developing mental disturbances.

OBJECTIVE

To identify the existing evidence regarding the association of mental health with outbreaks of the influenza A (H1N1), Zika, Ebola, and SARS-CoV-2 virus in exposed youth and adolescents in LMICs.

EVIDENCE REVIEW

Across 6 databases (Embase, Cochrane Library, PubMed, PsycINFO, Scopus, and Web of Science), the mental health outcomes of adolescents and youth (aged 10-24 years) associated with 4 major pandemic outbreaks from January 2009 to January 2021 in LMICs were reviewed. A group of 3 authors at each stage carried out the screening, selection, and quality assessment using Joanna Briggs Institute checklists. The social determinants of adolescent well-being framework was used as a guide to organizing the review.

FINDINGS

A total of 57 studies fulfilled the search criteria, 55 related to the SARS-CoV-2 (COVID-19) pandemic and 2 covered the H1N1 influenza epidemics. There were no studies associated with Zika or Ebola outbreaks that met screening criteria. The studies reported high rates of anxiety and depressive symptoms among adolescents, including posttraumatic stress disorder, general stress, and health-related anxiety. Potential risk factors associated with poor mental health outcomes included female sex; home residence in areas with strict lockdown limitations on social and physical movement; reduced physical activity; poor parental, family, or social support; previous exposure to COVID-19 infection; or being part of an already vulnerable group (eg, previous psychiatric conditions, childhood trauma, or HIV infection).

CONCLUSIONS AND RELEVANCE

Results of this systematic scoping review suggest that the COVID-19 pandemic and H1N1 epidemic were associated with adverse mental health among adolescents and youth from LMICs. Vulnerable youth and adolescents may be at higher risk of developing mental health-related complications, requiring more responsive interventions and further research. Geographically localized disease outbreaks such as Ebola, Zika, and H1N1 influenza are highly understudied and warrant future investigation.

Lockdown in Chinese university dormitories: Significant increase in negative feelings and time perception distortion

The COVID-19 pandemic has led to a global crisis resulting in lockdowns worldwide. Studies found that these could amplify negative affects predictive of disturbances in time perception. However, all existing studies on this topic concentrated on the general population during a lockdown at home. There was no research on university students living in dormitories. This study fills a gap in the literature by investigating the affective states and awareness of the passage of time of Chinese university students during an exceptional dormitory lockdown. Using a snowball sampling approach, this web-based study recruited 225 volunteers (136 girls, 17-27 years old) during a dormitory lockdown. The online survey consisted of questions on demographic information, affective states (the Chinese version of the depression anxiety stress scales-21 (DASS-21) on depression, anxiety, and stress), and sense of the passage of time (the translated version of the assessment of passage of time over daily, weekly and yearly periods). The researchers shared the questionnaire link via the social media application WeChat. The study applied descriptive statistics and column charts to represent students' affective states and sense of the passage of time under extreme conditions and Pearson's correlation analysis to examine the impact of affective states on their sense of time. The study's results indicate that the dormitory lockdown caused a significant increase in all depression, anxiety, and stress categories of the DASS-21, as well as a distortion of the sense of time passing. However, the direction of the distortion differed from that in previous studies. Moreover, a Pearson correlation analysis showed that none of the three negative affects could be associated with students' sense of time. The findings of this study indicate an increased vulnerability of students due to the lockdown. Their emotions were strongly affected, requiring particular interventions to preserve their mental well-being. In addition, they showed a different distortion direction of time passage. Finally, they differed in the correlations between negative affect and the sense of passage of time compared to the general population in lockdown at home. This shows a need to investigate the impact of psychological states on students' routines and quality of life in emergencies. This study's scope should be expanded by incorporating additional factors pertaining to the passage of time and by integrating cross-cultural comparisons.

The impact of the COVID-19 epidemic on students’ mental health: A cross-sectional study

Background

The COVID-19 pandemic is currently one of the biggest public health threats for people’s mental health. A particularly endangered group were students, who became highly affected by measures of social distance due to their active lifestyle. Therefore, the aim of this paper is to assess the level of self-reported stress, anxiety and depression of the student population in Serbia, in relation to demographic characteristics, living and studying conditions, students’ activities during the epidemic, potential coronavirus infection and general, mental and physical health.

Methods

We conducted a cross-sectional study of 580 undergraduate medical students from the University of Belgrade during the 2020/2021 school year. Mental health data were collected using the Depression Anxiety Stress Scales (DASS-21). Both bivariate and multivariate logistic regression analysis were used to examine the association between independent variables with the dependent variable mental health.

Results

Women made up the majority of the sample with 80.3%. A total of 64.5%, 66.8% and 66.7% of students between the ages of 21 and 30 had severe depressive symptoms, severe degree of anxiety, and a severe degree of stress, respectively. Women almost twice as often (OR = 1.89) assessed their anxiety as severe and almost two and a half times more (OR = 2.39) perceived stress as severe compared to men. Students who lived with their families during studies two and a half times (OR = 2.57) more often assessed their stress as severe, compared to students who lived alone. Fifth- and sixth-year students were less likely to rate depression and anxiety as serious than the first-year students.

Conclusions

Medical students reported their health as severely impaired in terms of depression, anxiety and stress reactions. The results indicate the need to launch a mental health program in the form of counseling and emotional support to students affected by the pandemic.

Associations between early-life stress exposure and internalizing symptomatology during the COVID-19 pandemic: Assessing the role of neurobehavioral mediators

Background

The ongoing COVID-19 pandemic is a major stressor that has been associated with increased risk for psychiatric illness in the general population. Recent work has highlighted that experiences of early-life stress (ELS) may impact individuals' psychological functioning and vulnerability for developing internalizing psychopathology in response to pandemic-related stress. However, little is known about the neurobehavioral factors that may mediate the association between ELS exposure and COVID-related internalizing symptomatology. The current study sought to examine the mediating roles of pre-pandemic resting-state frontoamygdala connectivity and concurrent emotion regulation (ER) in the association between ELS and pandemic-related internalizing symptomatology.

Methods

Retrospective life-stress histories, concurrent self-reported ER strategies (i.e., reappraisal and suppression), concurrent self-reported internalizing symptomatology (i.e., depression- and anxiety-related symptomatology), and resting-state functional connectivity data from a sample of adults (N = 64, M age = 22.12, female = 68.75%) were utilized.

Results

There were no significant direct associations between ELS and COVID-related internalizing symptomatology. Neither frontoamygdala functional connectivity nor ER strategy use mediated an association between ELS and COVID-related internalizing symptomatology (ps > 0.05). Exploratory analyses identified a significant moderating effect of reappraisal use on the association between ELS and internalizing symptomatology (β = -0.818, p = 0.047), such that increased reappraisal use buffered the impact of ELS on psychopathology.

Conclusions

While frontoamygdala connectivity and ER do not appear to mediate the association between ELS and COVID-related internalizing symptomatology, our findings suggest that the use of reappraisal may buffer against the effect of ELS on mental health during the pandemic.

Prevalence of anxiety symptoms among Chinese university students amid the COVID-19 pandemic: A systematic review and meta-analysis

College students in China are particularly vulnerable to worry. In the meanwhile, the COVID-19 pandemic might worsen anxiety symptoms. However, due to the inconsistency of many studies regarding anxiety symptoms, it has proven challenging to provide accurate psychiatric health treatments to undergraduates. Therefore, in order to determine the prevalence of anxiety among Chinese university students during the COVID-19 epidemic, this study will undertake a systematic review and meta-analysis.

English databases (i.e Embase (Ovid), APA PsycInfo, Medline, Pubmed, Cochrane Library) were utilized to identify papers that provide information on the incidence of anxiety among Chinese college students during the pandemic. Two authors evaluated the qualifications of relevant studies, assessed the risk of bias (RoB), and retrieved data. RoB was evaluated using the cross-sectional study quality evaluation criteria from the American Agency for HealthCare Quality and Research (AHRQ). Three hundred seventy-three records were retrieved. Twenty-five studies were eventually included, involving 1,003,743 Chinese college students. The findings of the study identified that the pooled prevalence of anxiety symptoms was 25.0% (95% CI: 21%–29%, P < 0.001), and those among medical-related professionals were lower than those of the general population (22.1% vs. 25%, P < 0.001). In addition, the prevalence of studies with more female respondents was higher than those with fewer female respondents (26.4% vs. 8%). In the later phases of the COVID-19 pandemic compared to the early stages, anxiety prevalence is higher (29.1% vs. 17.2%). Finally, using meta-regression to explore the source of heterogeneity, this study found that the most potential source was whether the graduate students or otherwise.

This meta-analysis revealed that during the COVID-19 pandemic, a quarter of Chinese college students had anxiety symptoms. Therefore, it is necessary to provide continuous psychological assessment and treatment services for college students.

Mental Health Risk Factors and Coping Strategies among Students in Asia Pacific during COVID-19 Pandemic—A Scoping Review

The impact of COVID-19 has forced higher education institutes to go into lockdown in order to curb the situation. This sudden change caused students within the institutions to forgo traditional face to face classroom settings and to attend immediate online classes. This review aims to summarize the evidence of the social demographic mental health impacts of the COVID-19 pandemic on students in higher education institutes within the Asia Pacific region and identify the coping mechanisms adopted during these times. A systematic literature search was conducted using three databases (PubMed, Google Scholar, and Scopus), out of which 64 studies met the inclusion/exclusion criteria. The findings revealed that the social demographic groups most at risk were female students, those who were in the final years of their studies (i.e., students who were almost graduating), and postgraduate students as well as students studying medical fields (nursing, dental, medicine, health sciences etc.). The majority of the studies identified that students were relying on mobile devices and extended screen time to cope with the pandemic. Having proper social support, be it through a network of friends or positive family cohesion, can be a good buffer against the mental impacts of COVID-19. Students in higher education institutes are at risk of mental consequences due to COVID-19. By reducing their screen time, finding a healthier coping system, increasing the availability of support within the family and community, as well as actively engaging in beneficial activities students may be able to alleviate general negative emotions, specifically during the pandemic.

Correlation between reduced telomere length and behavioural and emotional problems in left-behind children in a rural area in China

Evidence shows that being left behind experience (LBE) during childhood may increase the risks of poor psychopathological outcomes. However, it is unclear to what extent the mental health is affected by the LBE. Telomere length (TL), one of the most extensively studied biological markers of cellular ageing, provides a valuable tool for exploring the potential effects of parent-child separation on psychological problems by integrating genetic and environmental factors. In this study, a total of 613 children (mean age = 10.77, SD = 1.92) were recruited from the rural area of Deyang, Sichuan Province, China. We used a self-designed questionnaire to assess LBE, and collected psychopathological outcomes by using the Piers-Harris Children's Self-concept Scale, the Teacher's Report Form 6/18 and the Youth Self-Report 11/18. Terminal restriction fragment analysis was used to measure TL in peripheral blood leukocytes. Analyses revealed that 342 out of 613 participants (55.79%) were Left-behind children. LBE was observed to associated with shorter TL, lower self-esteem, and increased behavioural and emotional problems. The cumulative effects of LBE may be reflected by greater altered telomere homeostasis, decreased self-esteem, and worsened behavioural and emotional problems. The association of the total time of being left behind with self-esteem and behavioural and emotional problems was significantly mediated by altered telomere homeostasis, with estimated effects of 14.19%, 47.95% and 45.13%, respectively. The LBE in childhood, especially prolonged parent-child separation, increases the risk of mental health problems in childhood and adolescence.

The impact of adverse childhood experiences and recent life events on anxiety and quality of life in university students

Adverse childhood experiences (ACEs) have been repeatedly associated with a wide range of physical and mental health issues. Research has indicated high levels of anxiety and depression among university students, and a few studies have documented the relationship between ACEs and anxiety in the university student population. This study surveyed first year students at a university located in the most ethnically diverse district in England, with the second highest poverty rate. Eight hundred and fifty-eight responded; a response rate of 12%. The survey included questions about adverse childhood events, recent life stressors, current deprivation, quality of life, positive physical health and positive mental health, and used the Generalized Anxiety Disorder Scale, a standardised measure. Thirty-seven percent of the responding students met the diagnosis for generalised anxiety disorder. In a multivariate multiple regression model, life stressors and childhood adversities were significantly associated with higher levels of anxiety and lower levels of physical and mental health. Only childhood adversities significantly predicted lower levels of quality of life. The findings highlight the importance of considering adverse childhood experiences in enhancing the wellbeing of the student population. Given the demographics of the student population at the University of East London, the high rates of ACEs and anxiety are likely to partially reflect poverty and racism. The implications of the findings for trauma-informed policies and practices in universities are discussed.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10734-021-00774-9.

Associations Between Childhood Stressors, COVID-19-Related Anxiety, and Sleep Quality of Adults During the Third Wave of the COVID-19 Pandemic in Israel

PURPOSE

Studies point to a persistent effect of the COVID-19 pandemic on sleep quality and mental health, including anxiety. Exposure to stressors during childhood increases the susceptibility to anxiety in later life. Given the negative effects of anxiety on sleep quality, the present study aimed to examine the associations between various childhood stressors and poor sleep quality of adults during the COVID-19 pandemic, and whether these associations are mediated by COVID-19-related anxiety.

PARTICIPANTS AND METHODS

A total of 586 participants aged 18-40 (mean age 27.53± 6.48 years, 301 females) were recruited to take part in an online survey conducted in Israel between February 7 and 15, 2021, during the third wave of the COVID-19 pandemic. Participants completed questionnaires assessing retrospectively adverse childhood experiences (ACEs), childhood harshness (indexed separately by exposure to morbidity and mortality and low socioeconomic status, SES), and childhood unpredictability. COVID-19-related anxiety was assessed using two items. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and insomnia symptoms with the Insomnia Severity Index (ISI). Participants were asked to complete the ISI concerning two time points: (a) retrospectively, before the COVID-19 outbreak, and (b) currently, during the pandemic.

RESULTS

Path analysis indicated that poor sleep quality (PSQI) was directly and indirectly (through COVID-19-related anxiety) predicted by the number of ACEs and childhood morbidity-mortality exposure, directly predicted by childhood low SES, and indirectly predicted by childhood unpredictability. Insomnia symptoms increase (ISI) was indirectly predicted by the number of ACEs, childhood morbidity-mortality exposure, and childhood unpredictability.

CONCLUSION

ACEs as well as harsh and unpredictable childhood environments are predictive of poorer sleep during the COVID-19 pandemic. COVID-19-related anxiety mediates the effects of childhood stressors (other than low SES) on sleep. These findings may have clinical implications relevant to stressful periods in general.

Post-secondary Student Mental Health During COVID-19: A Meta-Analysis

The COVID-19 pandemic has posed notable challenges to post-secondary students, causing concern for their psychological well-being. In the face of school closures, academic disruptions, and constraints on social gatherings, it is crucial to understand the extent to which mental health among post-secondary students has been impacted in order to inform support implementation for this population. The present meta-analysis examines the global prevalence of clinically significant depression and anxiety among post-secondary students during the COVID-19 pandemic. Several moderator analyses were also performed to examine sources of variability in depression and anxiety prevalence rates. A systematic search was conducted across six databases on May 3, 2021, yielding a total of 176 studies (1,732,456 participants) which met inclusion criteria. Random-effects meta-analyses of 126 studies assessing depression symptoms and 144 studies assessing anxiety symptoms were conducted. The pooled prevalence estimates of clinically elevated depressive and anxiety symptoms for post-secondary students during the COVID-19 pandemic was 30.6% (95% CI: 0.274, 0.340) and 28.2% (CI: 0.246, 0.321), respectively. The month of data collection and geographical region were determined to be significant moderators. However, student age, sex, type (i.e., healthcare student vs. non-healthcare student), and level of training (i.e., undergraduate, university or college generally; graduate, medical, post-doctorate, fellow, trainee), were not sources of variability in pooled rates of depression and anxiety symptoms during the pandemic. The current study indicates a call for continued access to mental health services to ensure post-secondary students receive adequate support during and after the COVID-19 pandemic. Systematic Review Registration: PROSPERO website: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021253547.

Relationship between higher education teachers' affect and their psychological adjustment to online teaching during the COVID-19 pandemic: an application of latent profile analysis

Background

The COVID-19 outbreak has forced teachers to transition to online teaching, requiring them to adapt their courses and pedagogical methods to an online format rapidly without relevant training. This has presented a formidable challenge to higher education teachers. The present study uses a person-centered approach to identify heterogeneity among higher education teachers’ affective experiences and the relationship between this heterogeneity and their psychological adjustment to online teaching.

Methods

In total, 2,104 teachers in higher education institutions in Southern China were surveyed using the Positive and Negative Affect Schedule and the Psychological Adjustment to Online Teaching Scale (a measure developed for this study) between March 25 and March 31, 2020. The collected data were analyzed using latent profile analysis.

Results

Based on their affective experiences during online teaching immediately after the COVID-19 outbreak, higher education teachers were divided into three latent classes: the common, ambivalent, and positive types. Among them, the positive type accounted for the largest proportion (44.85%), while the ambivalent type accounted for the smallest proportion (23.93%). The rest was the common type, which accounted for 31.15%. Significant differences in psychological adjustment to online teaching were found between the three latent classes. Regarding positive psychological adjustment, teachers belonging to the ambivalent type had significantly lower scores than those belonging to the other two types. Further, the common type had a significantly lower score than the positive type. Regarding negative psychological adjustment, the ambivalent type had a significantly higher score than the other two types, and the common type had a significantly higher score than the positive type.

Conclusion

Based on a novel person-centered perspective, this study revealed the differences and complexity in higher education teachers’ affective experiences of online teaching immediately after the COVID-19 outbreak. The three different types of affective experiences (common, ambivalent, and positive) had a significant influence on psychological adjustment, with teachers belonging to the ambivalent type showing the worst psychological adjustment. This study provides a new perspective for the discussion of the relationship between teachers’ affective experiences and their psychological adjustment to online teaching.

Influence of Digital Competence on Perceived Stress, Burnout and Well-Being Among Students Studying Online During the COVID-19 Lockdown: A 4-Country Perspective

PURPOSE

This paper aims to reveal the influence of digital competence on perceived stress, burnout and well-being among students studying online during the COVID-19 lockdown in the spring of 2020 and to compare this influence on the basis of studies conducted in four countries.

METHODS

An exploratory study was conducted in Poland, Lithuania, Turkey and India using a cross-sectional research design. A total of 1097 respondents took part in the survey. Well-being was measured by the World Health Organization (WHO) Well-being Index, stress was evaluated using a psychological stress measure (PSM-9) instrument, burnout was evaluated using the Copenhagen Burnout inventory, and digital competence was measured by the Digital Competency Profiler (DCP).

RESULTS

The results revealed that social and informational dimensions of digital competencies had a positive influence on dealing with stress or burnout and improved well-being of students studying online during the COVID-19 lockdown. Moreover, the analysis on a country level highlighted that with regard to dealing with stress and burnout, the epistemological dimension of digital competence was the most important for Lithuanians and Indians, the informational dimension for Polish students and the social dimension for Turkish students.

CONCLUSION

The findings support the importance of digital competence on perceived stress, burnout and well-being among students studying online during the COVID-19 lockdown and propose deeper research directions on this phenomenon.

Prevalence of problematic Internet use and its association with quality of life among undergraduate nursing students in the later stage of COVID-19 pandemic era in China

Background and Objectives

The prevalence of problematic Internet use (PIU) in the post‐COVID‐19 pandemic era is not known. This cross‐sectional study aimed to determine the prevalence of PIU among baccalaureate nursing students (hereafter: nursing students) in the post‐COVID‐19 era.

Methods

A total of 1070 nursing students were consecutively invited to participate in this study from the nursing schools of five universities. PIU and quality of life (QOL) were assessed using the Internet Addiction Test (IAT) and the World Health Organization Quality of Life Scale Brief Version (WHOQOL‐BREF), respectively. t Tests, χ², tests, and Kruskal–Wallis tests were used to compare basic demographic and clinical characteristics between participants with and without PIU. Binary logistic regression analysis was used to examine independent correlates.

Results

The prevalence of PIU was 23.3% (95% confidence interval [CI]: 20.7%–25.8%). Multiple logistic regression analysis revealed that second‐ (p = .024) and third‐year (p = .012) students were more likely to suffer from PIU compared with first year students. Students with more severe depressive (p = .014) and anxiety symptoms (p = .011) were independently and significantly associated with more severe PIU. After controlling for covariates, nursing students with PIU had a lower overall QOL score (p = .002).

Conclusion and Scientific Significance

Problematic Internet use (PIU) was common among nursing students in the post‐COVID‐19 era. Considering the negative impact of PIU on QOL and academic performance, regular screening should be conducted and effective interventions implemented for nursing students with PIU. This was the first study on the prevalence of PIU among nursing students in the post‐COVID‐19 era. The findings of this study could help health professionals and education authorities to understand the patterns of PIU and its influence on QOL among nursing students and to allocate health resources and develop effective measures to reduce the risk of PIU in this population.

Prevalence of depressive symptoms among Chinese university students amid the COVID-19 pandemic: a systematic review and meta-analysis

AIMS

Chinese university students are at high risk for depressive symptoms and the ongoing coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the mental health of university students. However, existing studies on depressive symptoms in Chinese university students during the COVID-19 pandemic reported a wide range of prevalence estimates, making mental health planning for this population difficult. The objective of this study was to conduct a systematic review and meta-analysis of surveys that assessed the prevalence of depressive symptoms in Chinese university students amid the COVID-19 pandemic.

METHODS

Major Chinese (CNKI, Wanfang, VIP) and English (PubMed, Embase, PsycInfo) databases and preprint platforms were searched to identify cross-sectional studies containing data on the prevalence of depressive symptoms in Chinese university students during the pandemic. Two authors independently retrieved the literature, evaluated the eligibility of potential studies, assessed the risk of bias (RoB) of included studies, and extracted data. RoB was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

RESULTS

In total, 1177 records were retrieved, and 84 studies involving 1 292 811 Chinese university students during the pandemic were included. None of the included studies were rated as completely low RoB. Statistically significant heterogeneity in the prevalence estimates of included studies was detected (I2 = 99.9%, p < 0.001). The pooled prevalence of depressive symptoms was 26.0% (95%CI: 23.3-28.9%), which was significantly higher in female than in male students (30.8% v. 28.6%, p < 0.001), in postgraduates than in undergraduates (29.3% v. 22.9%, p < 0.001), in students living inside than in those living outside the COVID-19 epicentre (27.5% v. 22.3%, P < 0.001), in students from universities at the epicentre than in those from universities outside the epicentre (26.2% v. 23.1%, p < 0.001), in students who had close contact with COVID-19 than in those who did not (46.0% v. 25.0%, p < 0.001), and in students who had acquaintances or relatives infected with COVID-19 (39.7% v. 24.0%, p < 0.001) than in those who did not. Five sources of heterogeneity were identified from the subgroup analysis: survey period, % of males among the survey sample, scale of depressive symptoms, cutoff score of the scale and level of RoB.

CONCLUSIONS

Over one-fourth of Chinese university students experienced depressive symptoms during the COVID-19 pandemic. Mental health services for this population should include periodic evaluation of depressive symptoms, expanded social support and psychiatric assessment and treatment when necessary. It is also necessary to design depression prevention programmes that target higher-risk cohorts of university students.

Childhood Trauma and Mental Health Status in General Population: A Series Mediation Examination of Psychological Distress in COVID-19 Pandemic and Global Sleep Quality

Background: Coronavirus-2019 (COVID-19) has been coexisting with humans for almost 2 years, consistently impacting people's daily life, medical environment, and mental health. This study aimed to test the series mediation model triggered by childhood trauma, in which perceived psychological impact of COVID-19 pandemic and sleep quality mediated the path sequentially and led to adverse mental health outcomes. Methods: A cross-sectional design involving 817 participants were enrolled via WeChat online survey. Participants completed questionnaires, including demographic features, the Childhood Trauma Questionnaire, Impact of Event Scale-Revised (IES-R) questionnaire, Pittsburgh Sleep Quality Index (PSQI) questionnaire, and Depression, Anxiety, and Stress Scale (DASS-21). Pearson correlations and hierarchical multiple linear regression were employed to examine the association of childhood trauma and psychological stress of COVID-19, sleep quality, and mental health status. In addition, a series mediate analysis was carried out to examine sequence mediating effects of psychological impact of COVID-19 and sleep quality between childhood trauma and mental health status. Results: The results showed that childhood trauma is positively and significantly related to psychological distress of COVID-19 pandemic, sleep quality, and mental health status (p < 0.05). Hierarchical multiple linear regression analysis shown that demographic features explained 4.4, 2.1, and 4.0% of the total variance in DASS-21, IES-R, and PSQI total scale scores, respectively. Adding childhood trauma significantly increased the model variance of DASS-21 (ΔR ² = 0.129, F = 126.092, p = 0.000), IES-R (ΔR ² = 0.062, F = 54.771, p = 0.000), and PSQI total scale scores (ΔR ² = 0.055, F = 48.733, p = 0.000), respectively. Moreover, the series mediation model showed that the perceived impact of the COVID-19 pandemic and sleep quality were sequential mediators between childhood trauma and mental health status (proportion explained: 49.17%, p < 0.05). Conclusion: Amid the ravages of COVID-19, childhood trauma predicts poor mental health status, in part because of greater psychological impact related to COVID-19 and poorer global sleep quality. In order to improve mental health, future researchers should pay more attention to individuals with childhood trauma, for its association with greater stress related to life events and poorer sleep quality.

The Intersection Between Childhood Trauma, the COVID-19 Pandemic, and Trauma-related and Psychotic Symptoms in People With Psychotic Disorders

Introduction

People with psychotic disorders may be disproportionately affected by the traumatic effects of the COVID-19 pandemic. Childhood trauma, which also increases vulnerability to subsequent stressors, is common in individuals with psychosis. In this study, we investigated the intersection of the pandemic, childhood trauma, and psychotic and trauma-related symptoms in individuals with psychotic disorders.

Methods

We administered a cross-sectional survey to 151 participants [47 schizophrenia (SZ), 53 psychotic bipolar disorder (BP)], 51 healthy control (HC)] during the COVID-19 pandemic. Participants were asked about exposure to the pandemic’s impacts, childhood trauma, and post-traumatic stress, dissociative, and psychotic symptoms.

Results

BP reported greater negative impacts to emotional health than SZ and HC and to non-COVID physical health than HC. SZ reported less impact on work and employment during the pandemic. There were no other group differences in pandemic-related adversities. We also found that cumulative exposure to the pandemic’s negative impacts was significantly associated with PTSD symptoms but not psychotic or dissociative symptoms. Moreover, the number of adversities an individual experienced during the pandemic was strongly associated with the cumulative number of traumatic experiences they had in childhood.

Discussion

Our results suggest that having a psychotic disorder does not, in and of itself, increase susceptibility to the pandemic’s negative impacts. Instead, we provide evidence of a graded relationship between cumulative exposure to the pandemic’s negative impacts and PTSD symptom severity, as well as a graded relationship between cumulative childhood traumatic experiences and the number pandemic adversities, across diagnoses.