Mental health among university students: The associations of effort-reward imbalance and overcommitment with psychological distress

COVID-19 and University Students' Well-Being: An Ecological and Multidimensional Perspective on Post-Pandemic Effects

In February 2020, the Italian government started to adopt measures to contain the spread of COVID-19. This emergency had a strong impact on people's lives and daily activities, negatively affecting their well-being. One of the groups of people that suffered the most from the pandemic emergency and the related isolation was university students. Based on these considerations, this article analyzes the effects of COVID-19 on Italian students' well-being during three periods: the first lockdown (March-April 2020), one year later (March-April 2021), and two years after the lockdowns (March-April 2022). Three samples comprising a total of 765 participants (M = 21 years, SD = 2.87) completed an online self-report questionnaire, which included the I COPPE scale (its short form), a tool that measures the perception of present and future well-being, both as an overall evaluation and its six specific domains: interpersonal, community, occupational, physical, psychological, and economic. The results indicated a general trend in the well-being levels of university students from the beginning of the pandemic to 2022. Compared to 2020, in 2021, there was a sharp decline in well-being, whereas in 2022, there was an increase in well-being levels. Practical implications, limitations, and future recommendations arising from the present study are extensively discussed.

Well-being among university students in the post-COVID-19 era: a cross-country survey

University students have to handle crucial challenges for their future lives, such as succeeding in academic studies and finding attachment figures. These processes could potentially involve their well-being and mental health, with possible sociocultural differences based on the country of study. In order to explore such potential differences, a cross-sectional, multi-center survey was performed involving students from the University of Torino (Italy), Sevilla (Spain), and Lusòfona (Portugal). The survey, conducted from May to November 2023, investigated students' demographic and educational details, socioeconomic status, social support, mental health, academic environment, perceived COVID-19 pandemic impact, and future plans. Demographic profiles showed a predominance of female participants and straight sexual orientation, followed by bisexuality. Italian students showed the lowest levels of mental well-being and the highest rates of mental problems (anxiety and depression) and suicidal risk across the three countries despite the relatively similar profiles of social support. The prevalence of the students' confidence in their professional future is higher in Spain than in Italy and Portugal. This study provides a comprehensive examination of university students' mental health and well-being in three Southern European countries, addressing the major mental health challenges among university students and offering valuable insights for public health purposes.

Executive function, perceived stress and eating behaviours among Chinese young adults

Young adults in a transitional period may experience more stress and, hence, suffer from an increased risk of unhealthy eating. Executive function (EF) involves not only inhibitory control and mental flexibility (the 'cool' facet) to facilitate resistance to immediate temptations, but also affective decision making (the 'hot' facet) that helps to regulate emotional eating. The effects of different facets of EF and their interactions with perceived stress on eating behaviours remained underexplored. In this study, 594 young adults in their graduation year of post-secondary education were included. We used latent profile analysis to identify major patterns of eating behaviours and analysed their associations with perceived stress, and both the 'cool' and 'hot' facets of EF using multinominal logistic regression models. Latent profile analysis identified three clusters of eating patterns: non-approaching moderate eaters (N = 312, 52.5%), approaching eaters (N = 229, 38.6%), and approaching-and-avoidant eaters (N = 53, 8.9%). Logistic regression models found that the approaching-and-avoidant eating pattern was associated with higher perceived stress (OR = 3.16, p value = 0.007) and poorer affective decision-making (OR = 0.97, p value = 0.006). Stratified analysis further revealed that higher perceived stress was significantly associated with approaching-and-avoidant eating only among individuals with poorer affective decision-making. These findings suggest that individuals with poorer emotional regulation may face greater difficulties in regulating eating behaviours when experiencing higher stress. Interventions for people with a mixed pattern of approaching-and-avoidance eating should focus on providing support to regulate emotion-related eating.

University Students with Current Suicidal Ideation and Perceived Changes during the COVID-19 Pandemic: A Qualitative Study

INTRODUCTION

Mental health problems seemed to have increased among university students during the COVID-19 pandemic. To deepen our understanding of the pandemic's effects in this population, we conducted qualitative research to investigate any perceived changes in students during the pandemic, differentiating the sample based on the presence or absence of current suicidal ideation (SI).

METHODS

A wide sample of Italian university students (n = 1,214) completed an online questionnaire during the COVID-19 pandemic, March 2020-June 2021. We conducted a computer-assisted content analysis of an open-ended question about the perceived changes that occurred to them during the pandemic.

RESULTS

(1) Four thematic clusters were identified: "The psychological impact of the pandemic," "New ties and new loneliness," "An uncertain forethought" and "Discovering the value of relationships." (2) In subjects characterized by severe SI, the state of confinement at home was related to the most intense emotional states and worries. (3) Students with severe SI were different from the others, in particular using the lemma "panic," which was the only psychological state specifically associated with this group.

CONCLUSIONS

Students with current severe SI experienced higher level of psychological distress and suffering compared to the other groups during the pandemic.

Promotion of Healthy Habits in University Students: Literature Review

The increase in responsibilities, together with the multiple challenges that students face in the university period, has a direct impact on their healthy lifestyles. This literature review describes the benefits of promoting healthy habits in college, highlighting the fundamental role of prevention and promotion. A systematic review was carried out following the PRISMA recommendations, searching for information in the WOS and Scopus databases. On the other hand, a search was carried out within the existing and available grey literature. The review focused on finding information about physical activity, nutrition, and stress (with an emphasis on resilience and academic burnout) in university students. This bibliographic review includes 32 articles and six web pages, containing information on the benefits of physical activity, healthy habits, and health prevention. The information collected in this study shows that university students are exposed to multiple changes during this period, increasing as the academic years progress. At that time, their habits worsen, with low adherence to the Mediterranean diet, low physical activity, and high levels of stress, specifically increasing cases of academic burnout. The establishment of healthy habits during the university period is necessary, observing an improvement in all the variables studied. Prevention has played a fundamental role.

Configurational paths to turnover intention among primary public health workers in Liaoning Province, China: a fuzzy-set qualitative comparative analysis

BACKGROUND

A stable public health workforce plays an indispensable role in the realization of the goal of health for all. However, there is an exodus of public health workers from the Centers for Disease Control and Prevention (CDC). Given the limited evidence on the mechanisms shaping turnover intention (TI) among public health workers, the study aims to investigate the triggering mechanisms of high and low turnover intention by combining job demands, job resources, and personal resources through a set theory perspective based on the Job-Demand-Resources (JD-R) model.

METHODS

The cross-sectional study was conducted from September 7 to 18, 2020 at district (county) level CDC in Liaoning Province, China. A total of 584 public health professionals were included. Overcommitment, effort, social respect, occupational identity, job rewards, self-efficacy, and psychological resilience were included in the study as configuration factors. The data were gathered through an online questionnaire and were analyzed using multiple regression and fuzzy-set Qualitative Comparative Analysis (fsQCA).

RESULTS

Social respect (B = -0.682, P < 0.001), occupational identity (B = -0.168, P < 0.001), and effort (B = 0.114, P < 0.001) were associated with turnover intention. Five configurations for high turnover intention and five for low turnover intention were obtained through the fsQCA, with occupational identity and effort playing an essential role in all pathways. Moreover, the configurations for low turnover intention are not the antithesis of the configurations for high turnover intention.

CONCLUSION

Managers should synthesize the combined effects of factors when implementing interventions and formulating policies. Given the vital role of occupational identity and effort, mechanisms for the rational distribution of work to avoid excessive efforts and measures to promote occupational identity should be implemented to reduce the turnover intentions of primary public health workers and encourage their intention to stay.

Nursing students' academic conditions, psychological distress, and intention to leave school: A cross-sectional study

BACKGROUND

Psychological distress and intention to leave school are highly prevalent among nursing students. Academic conditions, including psychosocial stressors and school-work-life conflicts, could contribute to psychological distress and intention to leave school.

OBJECTIVE

To explore the associations between academic conditions and 1) psychological distress and 2) intention to leave school.

DESIGN

Cross-sectional correlational design.

SETTINGS

Data collection was performed in February and October 2021 in two nursing schools in Canada: Cegep (publicly funded college, technical degree) and university (bachelor's degree).

PARTICIPANTS

230 nursing students (Cegep 131, university 99).

METHODS

A self-administered online questionnaire assessed academic conditions (psychosocial stressors (Demand-Control-Support, Effort-Reward Imbalance and Overcommitment scales) and school-work-life conflicts (single item)), psychological distress (Kessler-6 scale), intention to leave school, and several covariates. Poisson robust multivariate regression models were built to explore the associations between academic conditions and 1) psychological distress and 2) intention to leave school.

RESULTS

A large proportion of participants experienced high efforts, school-work-life conflicts, overcommitment, and psychological distress (49.5-84.7 %). One out of five participants had had intention to leave school "many times" (Cegep 20.61 %; university 22.22 %). In adjusted analysis, overcommitment and school-work-life conflicts were associated with a higher prevalence of psychological distress (Prevalence ratio = 2.10; 95 % Confidence Intervals = 1.15-3.84 and Prevalence ratio = 2.32; 95 % Confidence Intervals = 1.24-4.32, respectively). Adverse associations were observed between effort-reward imbalance (Prevalence ratio = 2.32; 95 % Confidence Intervals = 1.09-4.94) as well as school-work-life conflicts (Prevalence ratio = 2.40; 95 % Confidence Intervals = 1.05-5.45) and intention to leave school.

CONCLUSIONS

Academic conditions might be risk factors for psychological distress and intention to leave school among nursing students. Interventions targeting modifiable academic conditions might improve nursing students' mental health and retention.

The role of psychological distress, stigma and coping strategies on help-seeking intentions in a sample of Italian college students

BACKGROUND

Mental health issues are common among university students, but the latter are unlikely to seek professional help even when mental health services are available. Coping strategies, stigma and psychological distress are often considered as factors that can affect help-seeking intentions in university students.

METHODS

This study aimed to determine the role of coping strategies, stigma and psychological distress on the intentions to seek professional help for psychological problems. All students (N = 13,886) from an Italian medium-sized university were asked to participate in a multidimensional online survey and 3754 (27.1%) agreed to participate. A Structural Equation Modelling approach was applied to explore the simultaneous direct and indirect effects of distress, stigma and coping strategies on professional help-seeking intentions.

RESULTS

Results showed that students were not very likely to seek professional help and, through the Structural Equation Model, psychological distress was found to be positively correlated with coping strategies, which in turn was negatively associated with the stigma of seeking help. The latter was negatively associated with professional help-seeking intentions. These effects suggest that students with significant psychological distress use coping strategies to face the stigma of seeking help: the lower the stigma of seeking help, the higher the chance of developing intentions to seek professional help.

CONCLUSIONS

This study suggests the importance of implementing programs to encourage college students to seek help, including measures that foster a stigma-free environment, reduce psychological distress and promote the use of adaptive coping strategies. Interventions should be focused firstly on self-stigma and secondly on perceived stigma, taking into consideration the level of psychological distress and social stereotypes associated with mental disorders and help seeking behaviours. Programs about coping are also essential and should focus on promoting emotion-focused strategies and problem-focused strategies.

The association between study conditions and hair cortisol in medical students in Germany - a cross-sectional study

BACKGROUND

Medical students often experience high levels of stress due to adverse study conditions, which may have adverse health consequences. Hair cortisol concentration (HCC) has been described as a physiological marker for chronic stress and might thus help to identify students under stress and examine the study conditions being responsible for long-term physiological stress responses. This study therefore investigated the association between study conditions and HCC in a sample of medical students.

METHODS

Fifty-five students from a medical school in Germany completed a paper-based questionnaire and had hair samples collected between May 2020 and July 2021. Study conditions were assessed with student versions of questionnaires based on the Job-Demand-Control-Support model (StrukStud, 25 items) and Effort-Reward Imbalance model (Student ERI, nine items). HCC of two centimeters closest to the scalp were determined by a cortisol luminescence immunoassay. Linear multiple regression analyses were performed to examine associations between study conditions and HCC.

RESULTS

Demands (B = 0.23, p = 0.002), effort (B = 0.12, p = 0.029) and the effort-reward-ratio (B = 0.28, p = 0.007) were positively associated with HCC in separate regression analyses, adjusted for age and sex. Only the association between demands and HCC remained significant when all components of the respective questionnaire were considered in the same model (B = 0.22, p = 0.003).

CONCLUSION

The results suggest that adverse study conditions may be associated with activation of the hypothalamic-pituitary-adrenal axis stress response as reflected by increased HCC. Longitudinal research is needed to confirm these cross-sectional results and examine effects of more prolonged stress due to adverse study conditions.

The Relationship Between Effort-Reward Imbalance and Depressive Symptoms Among Chinese Firefighters: Moderating by Coping Styles

OBJECTIVES

This study aims to examine the association between effort-reward imbalance (ERI) and depressive symptoms among Chinese firefighters and the moderating role of positive and negative coping styles in the above association.

METHODS

A cross-sectional study including 1328 male firefighters was conducted in China. We adopted the Center for Epidemiologic Studies Depression Scale to measure depressive symptoms.

RESULTS

Results showed that ERI was associated with depressive symptoms. Individuals with a higher ERI ratio and greater overcommitment were likely to have higher level of depressive symptoms. Furthermore, negative coping style strengthened the relationship between ERI ratio and overcommitment with depressive symptoms, whereas the positive coping style presented none significant moderation.

CONCLUSIONS

These findings indicate that reforming the effort-reward system might be helpful for mental health promotion among Chinese firefighters.

Associations between Poorer Mental Health with Work-Related Effort, Reward, and Overcommitment among a Sample of Formal US Solid Waste Workers during the COVID-19 Pandemic

Background

Effort-reward imbalance (ERI) and overcommitment at work have been associated poorer mental health. However, nonlinear and nonadditive effects have not been investigated previously.

Methods

The association between effort, reward, and overcommitment with odds of poorer mental health was examined among a sample of 68 formal United States waste workers (87% male). Traditional, logistic regression and Bayesian Kernel machine regression (BKMR) modeling was conducted. Models controlled for age, education level, race, gender, union status, and physical health status.

Results

The traditional, logistic regression found only overcommitment was significantly associated with poorer mental health (IQR increase: OR = 6.7; 95% CI: 1.7 to 25.5) when controlling for effort and reward (or ERI alone). Results from the BKMR showed that a simultaneous IQR increase in higher effort, lower reward, and higher overcommitment was associated with 6.6 (95% CI: 1.7 to 33.4) times significantly higher odds of poorer mental health. An IQR increase in overcommitment was associated with 5.6 (95% CI: 1.6 to 24.9) times significantly higher odds of poorer mental health when controlling for effort and reward. Higher effort and lower reward at work may not always be associated with poorer mental health but rather they may have an inverse, U-shaped relationship with mental health. No interaction between effort, reward, or overcommitment was observed.

Conclusion

When taking into the consideration the relationship between effort, reward, and overcommitment, overcommitment may be most indicative of poorer mental health. Organizations should assess their workers' perceptions of overcommitment to target potential areas of improvement to enhance mental health outcomes.

Psychometric properties of the effort-reward imbalance scale in Chinese version for university students

Objective

The main purpose of the study was to translate the Effort-Reward Imbalance Scale for University Students (ERIUS) and assess its psychometric properties in the Chinese cultural context.

Methods

We translated the original English version of the ERIUS into Chinese and undertook exploratory and confirmatory factor analysis using data collected from university students. The Stress Scale for College Students was selected as the criterion measure to examine the association between psychological stress and effort-reward imbalance. The validity and reliability of the translated version of the ERIUS were also assessed, and a sub-sample of participants (n = 120) completed the measure twice, with a two-week interval to assess test-retest reliability.

Result

Results of the exploratory factor analysis using data from 314 students showed that the Chinese version of the ERIUS had 14 items and 3 factors: effort, reward and overcommitment. Confirmatory factor analysis using data from 584 students showed that the Chinese version of the ERIUS had adequate structural validity (χ ² = 107.10, df = 32, RMSEA = 0.08, NFI = 0.90, CFI = 0.91, GFI = 0.90, PGFI = 0.62).

Conclusion

The Chinese version of the Effort-Reward Imbalance Scale for University Students has adequate psychometric properties in the Chinese cultural context and can be used as an effective tool to measure psychosocial stress of university students in China.

Health behavior interventions for university students measuring mental health outcomes: A scoping review

Introduction

Many university students have poor mental health, and co-occurring health risk behaviors. Targeting health behavior change in this population may improve mental health outcomes. This scoping review describes the extent and range of randomized controlled trials (RCT) evaluating interventions targeting health risk behaviors and measuring a mental health outcome, among university students.

Methods

Six electronic databases were searched for RCTs published until the 18^th May 2021. Eligible RCTs included university students, evaluated interventions that promoted health behavior change (i.e., dietary intake, physical activity, sedentary behavior, alcohol and drug use, smoking, and sleep), and measured a mental health-related outcome.

Results

Fifty-nine RCTs met the inclusion criteria that were published from 2000 to 2021, and over half (n = 33) were conducted in the United States. Interventions evaluated within the RCTs (n = 92) predominantly targeted changes to dietary intake (n = 41 interventions), physical activity (n = 39), or alcohol intake (n = 35). Most interventions targeted one (n = 51) or two (n = 27) health behaviors only. Included RCTs considered mental ill health outcomes (n = 24), psychological wellbeing outcomes (n = 20), or both (n = 15).

Discussion

This scoping review identified a moderate volume of experimental research investigating the impact of health behavior interventions on university students' mental health. There is scope for further research examining health behavior interventions targeting university students, particularly interventions taking a multi-behavioral approach.

A longitudinal cohort study observed increasing perfectionism and declining resilience, ambiguity tolerance and calling during medical school which is not explained by student personality

BACKGROUND

The medical degree is a long and challenging program, not just academically, but regarding the expectations engrained in the culture of medical education. The recent proliferation of literature on the poor mental well-being among students suggests a dilemma that often lays the onus on students to improve their health. The link between personality and vulnerability to psychological distress is acknowledged. This longitudinal study looked at personality in 1^st-year and changes in levels of certain psychological traits, as proxy indicators of well-being, in 4^th-year. We aimed to determine to what extent changes in psychological traits over time may be attributed to personality.

METHODS

Medical students completed surveys at the start (1^st-year: baseline) and finish (4^th-year: follow-up) of their medical degree (N = 154). Temperament and character personality, Perfectionism-Concern over mistakes (CoM), Ambiguity Tolerance, Resilience, Calling to medicine, and demographic variables were measured. Paired t-tests compared changes in psychological traits from baseline to follow-up. Linear regression examined whether personality at baseline would predict levels of psychological traits at follow-up.

RESULTS

The temperament and character profile of the sample was as expected, and congruent with previous studies, which describe a mature personality. Over four years, levels of Perfectionism-CoM significantly increased, while Resilience, Ambiguity Tolerance and Calling to medicine decreased. Harm Avoidance, Persistence, Self-Directedness and Cooperativeness at baseline significantly predicted levels of these traits at follow-up, but effect sizes were weak. Correlations were in the expected direction and weak.

CONCLUSIONS

Most commencing medical students, including this cohort, have mature personalities with an industrious temperament and an adaptable character. Yet over four years of medicine, Ambiguity Tolerance, Resilience and Calling declined while Perfectionism-CoM, already elevated at baseline, continued to increase to the final year. Of concern is the increased perfectionism that is strongly associated with poor mental health and psychological distress. The findings suggest a closer look at the entirety of the education environment and how its culture, including secondary school and the medical school admissions processes may influence these trends in students. As medical educators we should question why the pathway to medicine places such unhealthy pressure on students who aspire to be doctors.

Screening of substance use and mental health problems among Spanish medical students: A multicenter study

BACKGROUND

This study aimed to determine the prevalence of substance consumption and mental health problems among Spanish medical students, and their association with sociodemographic factors.

METHODS

A multicentre cross-sectional study was conducted. Self-reported data on sociodemographic and clinical characteristics were collected, including BDI-II, PHQ-9, brief STAI, and single-item academic burnout (IUBA).

RESULTS

Overall, 1265 students (74.2% female) completed the survey. Of them, 37.4% scored positive for depressive symptoms, as measured by the BDI-II, and more than half (53%) by the PHQ-9. Suicidal ideation was reported by about 12% whilst high levels of state and trait anxiety were informed by 28.8% and 29.4% of the students. The prevalence of burnout was 40.2%. Female and pre-clinical students reported significantly (p < 0.01) higher rates of depressive, anxiety, and burnout symptoms. Alcohol, energy drinks, and tobacco were the most frequently used substances. Total scores of self-reported mental health problems negatively correlated (p < 0.001) with objective academic results and positively correlated (p < 0.02) with the number of substances consumed in the last 30 days.

LIMITATIONS

Research-based on self-reported data could favour information bias due to the social desirability effect and memory error.

CONCLUSIONS

A high prevalence of substance consumption and several mental health problems was found among medical students, especially females. The relevant influence of academic-related factors on students' well-being may be a call for medical schools to implement initiatives aimed to improve students' ability to detect, address, and seek help for their mental health issues.

Development and validation of a nomogram for predicting the risk of mental health problems of factory workers and miners

OBJECTIVE

A nomogram for predicting the risk of mental health problems was established in a population of factory workers and miners, in order to quickly calculate the probability of a worker suffering from mental health problems.

METHODS

A cross-sectional survey of 7500 factory workers and miners in Urumqi was conducted by means of an electronic questionnaire using cluster sampling method. Participants were randomly assigned to the training group (70%) and the validation group (30%). Questionnaire-based survey was conducted to collect information. A least absolute shrinkage and selection operator (LASSO) regression model was used to screen the predictors related to the risk of mental health problems of the training group. Multivariate logistic regression analysis was applied to construct the prediction model. Calibration plots and receiver operating characteristic-derived area under the curve (AUC) were used for model validation. Decision curve analysis was applied to calculate the net benefit of the screening model.

RESULTS

A total of 7118 participants met the inclusion criteria and the data were randomly divided into a training group (n=4955) and a validation group (n=2163) in a ratio of 3:1. A total of 23 characteristics were included in this study and LASSO regression selected 12 characteristics such as education, professional title, age, Chinese Maslach Burnout Inventory, effort-reward imbalance, asbestos dust, hypertension, diabetes, working hours per day, working years, marital status and work schedule as predictors for the construction of the nomogram. In the validation group, the Brier score was 0.176, the calibration slope was 0.970 and the calibration curve of nomogram showed a good fit. The AUC of training group and verification group were 0.785 and 0.784, respectively.

CONCLUSION

The nomogram combining these 12 characteristics can be used to predict the risk of suffering mental health problems, providing a useful tool for quickly and accurately screening the risk of mental health problems.

Impact of effort–reward imbalance on undergraduates' aggressive behavior: The mediating role of perceived justice and hostile attribution

Effort–reward imbalance can predict aggressive behavior, but the mechanism of its influence is not yet clear to researchers. Thus, in this study we explored the mediating roles of perceived justice and hostile attribution in the relationship between effort–reward imbalance and aggressive behavior in an educational setting. Using the Effort–Reward Imbalance Scale for University Students, the Chinese version of the Perceived Justice Scale for College Students, the hostile attribution subscale of the Social Information Processing Attribution Bias Questionnaire, and the Chinese version of the Buss and Perry Aggression Questionnaire, we conducted a survey with 1,660 Chinese undergraduates. The results show that perceived justice played a mediating role in the relationship between effort–reward imbalance and aggressive behavior, as did hostile attribution. In addition, perceived justice and hostile attribution had a chain mediating effect in the link between effort–reward imbalance and aggressive behavior. Thus, effort–reward imbalance affects aggressive behavior not only directly but also indirectly through perceived justice and hostile attribution. Our findings enrich the literature on aggressive behavior by helping to understand how individuals become aggressive after the frustrating experience of receiving insufficient reward for their efforts.

Psychological counseling in the Italian academic context: Expected needs, activities, and target population in a large sample of students

University psychological counseling (UPC) is receiving growing attention as a means to promote mental health and academic success among young adults and prevent irregular attendance and dropout. However, thus far, little effort has been directed towards the implementation of services attuned to students’ expectations and needs. This work intends to contribute to the existing literature on this topic, by exploring the perceptions of UPC among a population of 39,277 students attending one of the largest universities in the South of Italy. Almost half of the total population correctly identified the UPC target population as university students, and about one third correctly expected personal distress to be the main need that UPC should target. However, a large percentage did not have a clear idea about UPC target needs, activities, and population. When two specific student subsamples were analyzed using a person-centered analysis, namely (i) those who expressed their intention to use the counseling service but had not yet done so and (ii) those who had already used it, the first subsample clustered into two groups, characterized by an “emotional” and a “psychopathological” focus, respectively, while the second subsample clustered into three groups with a “clinical”, “socioemotional”, and “learning” focus, respectively. This result shows a somewhat more “superficial” and “common” representation of UPC in the first subsample and a more “articulated” and “flexible” vision in the second subsample. Taken together, these findings suggest that UPC services could adopt “student-centered” strategies to both identify and reach wider audiences and specific student subgroups. Recommended strategies include robust communication campaigns to help students develop a differentiated perception of the available and diverse academic services, and the involvement of active students to remove the barriers of embarrassment and shame often linked to the stigma of using mental health services.

The Moderating Effects of Social Media Activities on the Relationship Between Effort-Reward Imbalance and Health and Wellbeing: A Case Study of the Oil and Gas Industry in Malaysia

Background

Social media activities affect every aspect of human life, be it personal, social or professional. Previous studies have confirmed the role of social media in affecting health in terms of releasing stress and providing social support. Increased occupational health disorders and increased time spent on social media activities motivate us to investigate this phenomenon in the context of occupational health. Therefore, the objective of this study is to measure the effects of social media activities related to personal and social life as well as work-life on health and wellbeing of office employees, on their job efforts and job rewards, and in moderating the effect of effort-reward imbalance on health and wellbeing.

Methods

Initially, to develop constructs related to social media activities, web-based structured interviews were conducted with five office employees working in the oil and gas industry for the last 5 years. Then, using an online questionnaire survey, data was collected from 424 office employees working in the oil and gas industry in Malaysia. Using statistical software for social science (SPSS) and Smart PLS, exploratory factor analysis and confirmatory factor analysis were conducted to identify reliability and validity (discriminant validity, convergent validity and composite validity) of the constructs. Following this, path analysis was conducted and the moderating effects were identified.

Results

Social media activities related to work-life decrease health and wellbeing by 11% and weaken the negative effect of effort-reward-imbalance on health and wellbeing by 17.6% at a 1% level of significance. The results of social media activities related to personal and social life strengthen the negative effect of effort-reward imbalance on health and wellbeing by 12% and negatively affects health and wellbeing and job rewards by 13, 55%, respectively. The direct effect of effort-reward imbalance and job efforts is significantly negative on health and wellbeing by 59 and 10%, respectively.

Conclusion

It is concluded that social media activities of the office employees significantly moderate the effect of effort-reward imbalance on health and wellbeing and intervene in job rewards in the organizations. Hence, the effect of social media activities reduces the health and wellbeing of office employees.

Gender moderates the association between chronic academic stress with top-down and bottom-up attention

Research on the relationship between chronic stress and cognition is limited by a lack of concurrent measurement of state-anxiety, physiological arousal, and gender. For the first time, we assessed the impact of these factors on top-down/conscious (simple and choice reaction time) and bottom-up/reflexive (saccadic reaction time) measures of attention using CONVIRT virtual-reality cognitive tests. Participants (N = 163) completed measures of academic stress (effort-reward imbalance; ERI) and state-anxiety while heart-rate variability was recorded continuously throughout the experiment. Gender moderated the association between academic stress with the top-down measures (b = -0.002, t = -2.023, p = .045; b = -0.063, t = -3.080, p = .002) and higher academic stress was associated with poorer/slower reaction times only for male participants. For bottom-up attention, heart rate variability moderated the relationship between academic stress and saccadic reaction time (b = 0.092, t = 1.991, p = .048), and only female participants who were more stressed (i.e., ERI ≥ 1) and displayed stronger sympathetic dominance had slower reaction times. Our findings align with emerging evidence that chronic stress is related to hyperarousal in women and cognitive decrements in men. Our findings suggest that higher ERI and sympathetic dominance during cognitive testing was associated with poorer bottom-up attention in women, whereas for men, academic stress was related with poorer top-down attention irrespective of sympathovagal balance.

Associations of university student life challenges with mental health and self-rated health: A longitudinal study with 6 months follow-up

BACKGROUND

Mental health problems are highly prevalent among university students. Stress due to student life challenges may be a risk factor for poorer health. This study investigates to what extent student life challenges and changes therein are associated with mental health and self-rated health.

METHODS

In a longitudinal study with 568 Italian university students mental health was assessed using the Mental Health Inventory-5 (MHI-5) and self-rated health with a single item from the Short Form 36 Health Survey (SF36) (score ranges: 0-100) at baseline and at six months follow-up. Student life challenges were investigated using six subscales (score ranges: 1-4) of the Higher Education Stress Inventory (HESI). A between-within linear regression model was used to investigate whether a higher exposure to life challenges was associated with poorer health (between individuals) and whether changes in student life challenges were associated with changes in health (within individuals).

RESULTS

Higher exposure to student life challenges was associated with poorer mental health (b ranging from -5.3 to -10.3) and self-rated health (b ranging from -3.1 to -9.6). An increase in student life challenges within individuals was associated with poorer mental health and self-rated health, in particular for high workload (b up to -5.9), faculty shortcomings (b up to -5.7), and unsupportive climate (b up to -5.6).

DISCUSSION

Exposure to student life challenges and changes therein are associated with university students' health. Our findings suggest that student life challenges may be a target for interventions to improve mental health and self-rated health among university students.