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Pan W, Zhou W, Wu J, Huang Z, Ding L, Lu X, Li X. A network analysis of daily stressors, subjective well-being, psychological distress and psychological capital during the COVID-19 pandemic. J Affect Disord 2024; 366:113-123. [PMID: 39197552 DOI: 10.1016/j.jad.2024.08.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 07/30/2024] [Accepted: 08/20/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND There is already considerable evidence suggesting the potential existence of a comprehensive system that reflects how individuals utilize psychological capital (PsyCap) to preserve mental health amid daily stressors during the COVID-19 pandemic. To explore the underlying mechanism of this system, the current study is the first to use network analysis showing the dimension-level correlation patterns of daily stressors, subjective well-being (SWB), psychological distress and PsyCap during the pandemic. METHOD We recruited 1556 participants in China and assessed daily stressors, SWB, psychological distress, and PsyCap through self-report questionnaires. A dimension-level network analysis was conducted to identify key dimensions and their associations. Relative importance analysis examined the contribution of each PsyCap dimension to SWB and psychological distress. RESULT Depression, anxiety and stress demonstrated high strength, and life satisfaction exhibited the highest bridge strength in the network. The great majority dimensions of daily stressors had positive connections with stress and anxiety, while financial restrictions and dissatisfaction with education/occupation had negative connections with life satisfaction. Self-efficacy and optimism were positively connected with life satisfaction. Hope and resilience were negatively connected with stress, as well as hope and optimism were negatively connected with depression. Optimism and self-efficacy made the highest contribution to SWB, while resilience made the highest contribution to psychological distress among PsyCap dimensions. CONCLUSION The findings elucidate the intricate relationship between daily stressors, SWB, psychological distress and PsyCap during the pandemic. Targeted interventions focusing on the specific PsyCap dimensions may enhance mental health outcomes in the post-COVID-19 era.
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Affiliation(s)
- Wei Pan
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China; School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan 430079, China
| | - Wenwei Zhou
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China; School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan 430079, China
| | - Junjie Wu
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China; School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan 430079, China
| | - Zhijing Huang
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China; School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan 430079, China
| | - Linjie Ding
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China; School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan 430079, China
| | - Xiaoyu Lu
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China; School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan 430079, China
| | - Xu Li
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China; School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan 430079, China.
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Luo W, Mohammed J. Mental health status and coping strategies of Chinese university students during the COVID-19 pandemic: A rapid review. PLoS One 2023; 18:e0296309. [PMID: 38134210 PMCID: PMC10745188 DOI: 10.1371/journal.pone.0296309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
Since the coronavirus (COVID-19) outbreak in December 2019, students have been under unparalleled psychological stress worldwide. As part of its prevention and control strategies, the Chinese Ministry of Education proposed online teaching activities for universities. For the first time, teaching and learning shifted completely online, significantly impacting university students used to classroom learning. This research addresses the knowledge gap about the mental health and coping strategies employed by Chinese university students during the COVID-19 pandemic. Electronic databases (PsycINFO, Scopus, Medline, Cochranes and CNKI) were searched systematically from 2019 to 2023, as part of this literature review. From the 349 articles found, 25 met the inclusion criteria for analysis. Thematic analysis was used to identify six sub-themes, organized under two main themes: Mental health issues of Chinese university students and their coping mechanisms. Heightened stress, anxiety, and depression appeared in Chinese university students during the pandemic, which may have been compounded by their isolation and the disruptions to their studies. Although the impact of COVID-19 on Chinese university students is waning, this study emphasizes the potential long-lasting impact on their mental health, which requires further investigation, particularly regarding gender differences. Moreover, positive and negative coping strategies were found in this review. Strategies for seeking social and family support and participating in sports activities had significant alleviating effects, while negative coping strategies such as alcohol-use and smoking did not. This rapid review informs the development of policies and interventions to enhance the mental health of university students during crisis events. The findings serve to inform health policymakers, university psychologists, and educators in improving the well-being of this student population.
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Affiliation(s)
- Wenjie Luo
- Department of Pharmacy, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Shiyan, China
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Jalal Mohammed
- Faculty of Health, University of Canterbury, Christchurch, New Zealand
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Chen B, Wang W, Yang S. The impact of family functioning on depression in college students: A moderated mediation model. J Affect Disord 2023; 340:448-455. [PMID: 37579887 DOI: 10.1016/j.jad.2023.08.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/18/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND The depression of college students is increasing. Family dysfunction is a potential risk factor for depression. More research is needed to uncover the relationship and influencing mechanism. Based on this, this study examined the mediating effect of coping style and the moderating effect of gender in family functioning and depression among college students. METHODS From May to June 2022, a cross-sectional survey was conducted among 2033 college students (16-24 years old) from universities in Anhui Province, China, including 1285 females (63.21 %) and 748 males (36.79 %), with an average age of 19.81 years old (SD = 1.22 years old). There were 651 (32.02 %) only child. Family functioning was assessed by Family Assessment Device, coping style was assessed by Simplified Coping Style Questionnaire and depression was assessed by Self-rating Depression Scale. Common method bias was performed by Harman's single-factor test. Mediating effect was analyzed by stepwise regression. Moderating effect was analyzed by moderated multiple regression. RESULTS There was no serious common method bias in this study. Good family functioning had a negative predictive effect on depression in college students (r = -0.56, p < 0.001). Coping style partially mediated the predictive effect of family functioning on depression, and the mediating effect accounted for 33.73 % of the total effect. The interaction term of family functioning and gender was significant predictor of coping style (β = 0.33, t = 2.69, p < 0.05) and depression (β = -1.98, t = -2.46, p < 0.05). CONCLUSIONS Good family functioning is a negative predictor of depression in college students. Coping style plays a partial mediating role between family functioning and depression. The first half path and the direct path of the mediation model are modulated by gender.
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Affiliation(s)
- Baoling Chen
- School of Management, Hefei University of Technology, Hefei, China; School of Finance and Public Administration, Anhui University of Finance & Economics, Bengbu, China.
| | - Weiwei Wang
- Internal Medicine Department, The Third People's Hospital of Bengbu, Bengbu, China
| | - Shanlin Yang
- School of Management, Hefei University of Technology, Hefei, China
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Wang Q, Duan R, Han F, Huang B, Wang W, Wang Q. The impact of core self-evaluation on school adaptation of high school students after their return to school during the COVID-19 pandemic: the parallel mediation of positive and negative coping styles. PeerJ 2023; 11:e15871. [PMID: 37927795 PMCID: PMC10624169 DOI: 10.7717/peerj.15871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/18/2023] [Indexed: 11/07/2023] Open
Abstract
Background To explore the direct effect of core self-evaluation and the indirect effects of positive and negative coping styles on school adaptation of high school students after their return to school during the COVID-19 pandemic. Methods The Core Self-Evaluation Scale, Simple Coping Style Scale, and School Adaptation Questionnaire were used for the psychometric analysis of 500 high school students (229 males and 271 females) one month after their return to school. The bootstrap method was applied for mediation analysis. Results A positive correlation was noted between core self-evaluation and school adaptation (r = 0.56), and the predictive effect was significant (β = 0.43). Core self-evaluation positively predicted positive coping styles, which positively predicted school adaptation, while core self-evaluation negatively predicted negative coping styles, which negatively predicted school adaptation. Positive and negative coping styles played a significant mediating role between core self-evaluation and school adaptation. The mediating effect included the indirect effects generated by two pathways: core self-evaluation → positive coping style → school adaptation (95% CI [0.08-0.19]) and core self-evaluation → negative coping style → school adaptation (95% CI [0.03-0.11]). Conclusion There is a positive association between the core self-evaluation and school adaptation of high school students after their return to school during the COVID-19 pandemic. It may directly or indirectly affect the school adaptation of high school students after their return to school through positive or negative coping styles. After returning to school, educators should guide students to view themselves positively, cultivate healthy core self-evaluation, and enable them to have good school adaptation.
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Affiliation(s)
- Qinglin Wang
- College of Medicine, Yangzhou University, Yangzhou, Jiangsu, China
| | - Ruirui Duan
- College of Physical Education, Yangzhou University, Yangzhou, Jiangsu, China
| | - Fulei Han
- College of Physical Education, Yangzhou University, Yangzhou, Jiangsu, China
| | - Beibei Huang
- College of Physical Education, Yangzhou University, Yangzhou, Jiangsu, China
| | - Wei Wang
- College of Physical Education, Yangzhou University, Yangzhou, Jiangsu, China
| | - Qiulin Wang
- College of Physical Education, Yangzhou University, Yangzhou, Jiangsu, China
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Wei J, Yun Z, Zhang Y, Mei X, Ba L, Peng H, Li N, Li M, Liu Z, Liu H. The status of e-learning, personality traits, and coping styles among medical students during the COVID-19 pandemic: a cross-sectional study. Front Psychiatry 2023; 14:1239583. [PMID: 37817833 PMCID: PMC10561257 DOI: 10.3389/fpsyt.2023.1239583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/04/2023] [Indexed: 10/12/2023] Open
Abstract
Objective The objective of this study was to explore the learning preferences and habits of medical students during the pandemic home e-learning, and to investigate the incidence of adverse emotions, optimistic character level and coping style. To explore the influencing factors of adverse emotions. Methods A cross-sectional survey was conducted in China from March to June 2022. Medical students were recruited from three universities in China, and a questionnaire survey was conducted. The questionnaires consisted of a "e-learning preferences and habits questionnaire", life orientation test questionnaire (LOT-R), and simple coping style questionnaire (SCSQ). Finally, a total of 492 medical students who met the inclusion and exclusion criteria became the research subjects and completed the survey. Results A total of 57.7% believed they experienced no adverse emotions during home e-learning. ① During the COVID-19 pandemic, the score of optimistic personality of medical students was (7.25 ± 1.933), and the score of pessimistic personality was (5.82 ± 2.240). The score of positive coping was (21.75 ± 5.379), and the score of negative coping was (11.75 ± 3.611). ② The occurrence of medical students' adverse emotions during e-learning was influenced by "Whether there is a private, quiet space to study", "Degree of knowledge mastery", "Physical discomfort or not", "Keep a regular schedule or not", "Optimistic personality tendency". Conclusion This study demonstrates the during home e-learning, most medical students have their own learning equipment and can meet their learning needs. Their favorite mobile device to use is a mobile phone, and their favorite method of teaching is to provide course playback. More than half of medical students believe that they have some inconvenience in conducting research during home e-learning. With regard to teacher's real-time screen, the largest number of medical students support teachers turning on live screens so that they feel like they are interacting with the teacher. The preference for blended teaching is highest among medical students. In general, medical students were highly adaptive of the newest e-learning approach. Based on the statistic analysis, the factors that "Whether there is a private, quiet space to study", "Degree of knowledge mastery", "Physical discomfort or not", "Keep a regular schedule or not", and "Optimistic personality tendency" may be the influencing factors for the occurrence of adverse emotions.
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Affiliation(s)
- Junfan Wei
- The Seventh Clinical Medicine College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | | | - Yang Zhang
- The Seventh Clinical Medicine College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Xiaoxiao Mei
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Li Ba
- The Seventh Clinical Medicine College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Huan Peng
- Nursing College of Fujian, University of Traditional Chinese Medicine, Fuzhou, China
| | - Na Li
- Nursing College of Fujian, University of Traditional Chinese Medicine, Fuzhou, China
| | - Meng Li
- Nursing Department of The Third People's Hospital of Henan Province, Zhengzhou, China
| | - Zhu Liu
- The Seventh Clinical Medicine College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Hanjiao Liu
- The Seventh Clinical Medicine College of Guangzhou University of Chinese Medicine, Shenzhen, China
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Lourie A, Kennedy S, Henshaw EJ, James D. College transition Fall 2020 and 2021: Understanding the relationship of COVID-19 experiences and psychosocial correlates with anxiety and depression. PLoS One 2023; 18:e0287792. [PMID: 37410788 PMCID: PMC10325039 DOI: 10.1371/journal.pone.0287792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/14/2023] [Indexed: 07/08/2023] Open
Abstract
Rates of mental health symptoms, particularly anxiety and depression, have increased significantly in college students in the past decade along with utilization of mental health resources. The COVID-19 pandemic created an additional source of stressors to an already challenging landscape of college transition. COVID-19 has been associated with an increase of anxiety among college students, particularly first year students, entering college in Fall 2020. The shifts in policy (e.g., federal, state, and college) accruing medical data, and vaccine availability between Fall 2020 and Fall 2021 provide an opportunity to examine the role of COVID-19 experiences in the transition to college for these two first-year student cohorts. This study examined two cohorts of first-year students, Fall 2020 and 2021, to better understand the relationship between COVID-19 experiences, psychosocial correlates, and mental health symptoms. Results suggest that for students in our Fall 2020 cohort COVID-19 experiences played a distinct role in the prediction of mental health symptoms while in Fall 2021 COVID-19 experiences did not uniquely contribute to prediction of mental health symptoms. These findings have implications for mental health interventions for first-year students transitioning to college.
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Affiliation(s)
- Andrea Lourie
- Department of Psychology, Denison University, Granville, Ohio, United States of America
| | - Susan Kennedy
- Department of Psychology, Denison University, Granville, Ohio, United States of America
| | - Erin J. Henshaw
- Department of Psychology, Denison University, Granville, Ohio, United States of America
| | - Drexler James
- Department of Psychology, University of Minnesota, Twin Cities, Minneapolis, MN, United States of America
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Haver A, Krampe H, Danbolt LJ, Stålsett G, Schnell T. Emotion regulation moderates the association between COVID-19 stress and mental distress: findings on buffering, exacerbation, and gender differences in a cross-sectional study from Norway. Front Psychol 2023; 14:1121986. [PMID: 38427783 PMCID: PMC10325689 DOI: 10.3389/fpsyg.2023.1121986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/15/2023] [Indexed: 02/01/2024] Open
Abstract
Background Maintaining good mental health is important during a crisis. However, little attention has been given to how people achieve this, or how they evaluate emotions associated with stressors, such as the COVID-19 pandemic. This study aims to (1) investigate whether emotion regulation, in particular cognitive reappraisal and suppression, moderates the relationship between COVID-19 stress and general mental distress and (2) examine gender differences in the interrelations between COVID-19 stress, emotion regulation, and mental distress. Methods Data from a population in Norway (n = 1.225) were collected using a cross-sectional survey during the early months of the COVID-19 pandemic. Emotion regulation was measured using the Emotion Regulation Questionnaire Scale (ERQ), COVID-19 stress with the COVID-19 Stress Scale, and mental distress with the Patient Health Questionnaire 4 (PHQ-4). Moderation analyses were conducted using the PROCESS macro for SPSS. Results There was a strong association between COVID-19 stress and general mental distress (r = 0.61). The moderation analyses showed substantial moderation effects of cognitive reappraisal and suppression on the relationship between COVID-19 stress and mental distress. Cognitive reappraisal served as a buffer (p = 0.001) and suppression (p = 0.002) exacerbated the relation between COVID-19 stress and mental distress. Men had higher scores of suppression (p < 0.001), and women had higher scores of cognitive reappraisal (p = 0.025). The buffering effect of cognitive reappraisal presented itself only in women (p < 0.001), while the exacerbation effect of suppression appeared only in men (p < 0.001). Conclusion The current study suggests that COVID-19 pandemic-related stress is easier to deal with for those who have the tendency to cognitively reappraise. In contrast, suppression is associated with symptoms of depression and anxiety. The prevention of mental distress can be supported by guiding people about the importance of using healthy emotion regulation strategies, as well as helping them to become more aware of the way they interpret and regulate their emotions. Gender differences in emotion regulation suggest gender awareness, e.g., tailored programs for men and women.
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Affiliation(s)
- Annie Haver
- Faculty of Social Sciences, Norwegian School of Hotel Management, University of Stavanger, Stavanger, Norway
- School of Psychology, Faculty of the Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Henning Krampe
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lars Johan Danbolt
- MF Norwegian School of Theology, Religion and Society, Majorstuen, Oslo, Norway
- Centre for Psychology of Religion, Innlandet Hospital Trust, Brumunddal, Norway
| | - Gry Stålsett
- MF Norwegian School of Theology, Religion and Society, Majorstuen, Oslo, Norway
- Modum Bad Psychiatric Center, Vikersund, Norway
| | - Tatjana Schnell
- MF Norwegian School of Theology, Religion and Society, Majorstuen, Oslo, Norway
- Existential Psychology Lab, Institute of Psychology, University of Innsbruck, Innsbruck, Tyrol, Austria
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Dell’Acqua C, Mura F, Messerotti Benvenuti S, Patron E, Palomba D. Reduced heart rate variability and expressive suppression interact to prospectively predict COVID-19 pandemic-related post-traumatic stress symptoms. Sci Rep 2022; 12:21311. [PMID: 36494439 PMCID: PMC9734110 DOI: 10.1038/s41598-022-25915-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic is a unique period of stress that, in some cases, led to post-traumatic stress symptoms (PTSSs). Emotion regulation strategies are known to modulate the emotional response to stressful events. Expressive suppression (ES) is a maladaptive strategy related to the exacerbation of the physiological stress response. Heart rate variability (HRV), an index of cardiac autonomic balance strictly related to ES, was also shown to predict PTSSs. This was the first study to investigate whether the pre-pandemic ES use and resting-state HRV predicted pandemic-related PTSSs. Before the pandemic, 83 (58 females) university students completed the Emotion Regulation Questionnaire (ERQ), self-report measures of anxiety and depressive symptoms, and a three-minute resting-state electrocardiogram recording. After 12 months, 61 (45 females) participants completed a self-report measure of pandemic-related PTSSs and repeated the self-report psychological measures. Pre-pandemic anxiety symptoms prospectively predicted greater PTSSs. Moreover, a significant interaction between HRV and ES in predicting PTSSs emerged, whereby those who had higher levels of ES and reduced HRV showed higher PTSSs. These findings suggest that an integrated assessment of HRV and ES might be useful for identifying individuals who are more vulnerable to the development of PTSSs during crises.
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Affiliation(s)
- Carola Dell’Acqua
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Francesca Mura
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Simone Messerotti Benvenuti
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy ,grid.411474.30000 0004 1760 2630Hospital Psychology Unit, Padua University Hospital, Padua, Italy
| | - Elisabetta Patron
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy
| | - Daniela Palomba
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
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Can G, Candemir G, Satici SA. Emotion regulation and subjective wellbeing among Turkish population: the mediating role of COVID-19 fear. CURRENT PSYCHOLOGY 2022:1-10. [PMID: 36345547 PMCID: PMC9631591 DOI: 10.1007/s12144-022-03771-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/10/2022] [Accepted: 09/13/2022] [Indexed: 11/05/2022]
Abstract
We examined fear of COVID-19 as a mediator of the relationship between emotion regulation (suppression, reappraisal) and subjective wellbeing. In this cross-sectional study, 1,014 Turkish individuals completed assessments of positive affect, negative affect, satisfaction with life, emotion regulation (suppression, reappraisal), and fear of COVID-19. Network analysis revealed that all variables were associated with each other. Structural equation modelling indicated that greater suppression was associated with greater fear of COVID-19 and less subjective wellbeing. Greater reappraisal was associated with less fear of COVID-19 and greater subjective wellbeing. In addition greater suppression was associated with less subjective well-being and greater reappraisal was associated with greater subjective well-being. Mediation analyses demonstrated that fear of COVID-19 partially mediated the relationship between suppression, reappraisal and subjective wellbeing. Findings expand our understanding of the link between emotion regulation and subjective wellbeing during the COVID-19 pandemic.
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Affiliation(s)
- Gurhan Can
- Department of Psychological Counselling, Hasan Kalyoncu University, Gaziantep, Türkiye
| | - Gulsah Candemir
- Psychological Counseling, Ministry of National Education, Osmaniye, Türkiye
| | - Seydi Ahmet Satici
- Department of Psychological Counselling, Yildiz Technical University, Istanbul, Türkiye
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Liang S, Liu C, Rotaru K, Li K, Wei X, Yuan S, Yang Q, Ren L, Liu X. The relations between emotion regulation, depression and anxiety among medical staff during the late stage of COVID-19 pandemic: a network analysis. Psychiatry Res 2022; 317:114863. [PMID: 36191555 PMCID: PMC9509294 DOI: 10.1016/j.psychres.2022.114863] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 01/04/2023]
Abstract
Existing research proposed that moving from a disorder-level analysis to a symptom-level analysis may provide a more fine-grained understanding of psychopathology. This study aimed to explore the relations between two dimensions (i.e., cognitive reappraisal, CR; expressive suppression, ES) of emotion regulation and individual symptoms of depression and anxiety among medical staff during the late stage of COVID-19 pandemic. We examined depression symptoms, anxiety symptoms and emotion regulation among 420 medical staff during the late stage of COVID-19 pandemic via network analysis. Two networks (i.e. emotion regulation-depression network and emotion regulation-anxiety network) were constructed in the present study. Bridge centrality index was calculated for each variable within the two networks. Among the present sample, the prevalences of depression and anxiety are 39.5% and 26.0%. CR and ES showed distinct connections to symptoms of depression and anxiety. Results of bridge centrality showed that in both networks, CR had a negative bridge expected influence value while ES had a positive bridge expected influence value. The results revealed the specific role of CR and ES in relation to depression and anxiety at a symptom level. Implications for clinical preventions and interventions are discussed.
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Affiliation(s)
- Shuyi Liang
- Department of Military Medical Psychology, Fourth Military Medical University, 169 West Changle Road, Xi'an, Shaanxi 710032, China
| | - Chang Liu
- BrainPark, School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3168, Australia
| | - Kristian Rotaru
- BrainPark, School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3168, Australia,Monash Business School, Monash University, Caulfield, VIC 3145, Australia
| | - Kuiliang Li
- Department of Psychology, Army Medical University, Chongqing 400038, China
| | - Xinyi Wei
- Department of Psychology, Renmin University of China, Beijing 100000, China
| | - Shangqing Yuan
- School of Psychology, Capital Normal University, Beijing 100089, China
| | - Qun Yang
- Department of Military Medical Psychology, Fourth Military Medical University, 169 West Changle Road, Xi'an, Shaanxi 710032, China
| | - Lei Ren
- Department of Military Medical Psychology, Fourth Military Medical University, 169 West Changle Road, Xi'an, Shaanxi 710032, China.
| | - Xufeng Liu
- Department of Military Medical Psychology, Fourth Military Medical University, 169 West Changle Road, Xi'an, Shaanxi 710032, China.
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Rozanov IA, Ryumin O, Karpova O, Shved D, Savinkina A, Kuznetsova P, Diaz Rey N, Shishenina K, Gushin V. Applications of methods of psychological support developed for astronauts for use in medical settings. Front Physiol 2022; 13:926597. [PMID: 36187769 PMCID: PMC9519135 DOI: 10.3389/fphys.2022.926597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/22/2022] [Indexed: 11/22/2022] Open
Abstract
Over the past 40 years, psychological support (PS) for cosmonauts and astronauts has remained an important part of the regular biomedical provision of space crews during extended orbital flights. It includes well-developed principles and a set of methods that have proven its effectiveness for the maintenance of behavioral health under extreme conditions of space flight. The main principle of PS in flight is to restore the usual sensory input to compensate for the monotony and lack of external stimuli as a result of a long stay under isolation and confinement. Risk factors for the psychological health and well-being defined for the astronauts, such as sensory and social deprivation, monotony, confinement, and lack of privacy, also remain part and parcel of several civil professions. These include polar wintering, submarines, working on oil platforms, and ocean fishing. Most of these factors also adversely affect the recovery rate of a large contingent of medical institutions, especially bedridden patients with chronic diseases. Finally, due to the negative epidemiological situation associated with the spread of COVID-19, an increasingly wide range of citizens forced to be in self-isolation faces negative manifestations of the deprivation phenomena described previously. Several cases of successful use of PS under isolation, monotony, crowding, and confinement are presented. Thus, we assume that the use of psychological support methods developed for space flights could be extremely relevant in civil medicine and everyday life.
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Affiliation(s)
- Ivan A. Rozanov
- Russian Federation State Scientific Center, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
- *Correspondence: Ivan A. Rozanov,
| | - Oleg Ryumin
- Russian Federation State Scientific Center, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - Olga Karpova
- Russian Federation State Scientific Center, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - Dmitry Shved
- Russian Federation State Scientific Center, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
- Moscow Aviation Institute, National Research University, Moscow, Russia
| | - Alexandra Savinkina
- Russian Federation State Scientific Center, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - Polina Kuznetsova
- Russian Federation State Scientific Center, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | | | | | - Vadim Gushin
- Russian Federation State Scientific Center, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
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Carola V, Vincenzo C, Morale C, Pelli M, Rocco M, Nicolais G. Psychological health in COVID-19 patients after discharge from an intensive care unit. Front Public Health 2022; 10:951136. [PMID: 36033791 PMCID: PMC9411785 DOI: 10.3389/fpubh.2022.951136] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/21/2022] [Indexed: 01/24/2023] Open
Abstract
Along with physical changes, psychological changes are detectable in patients with COVID-19. In these patients, the stressful experience of intensive care unit (ICU) hospitalization may aggravate psychological conditions. Our study examines the short- and long-term psychological consequences of COVID-19 in ICU patients. COVID-19 patients completed the self-rating questionnaires Kessler 10 Psychological Distress Scale (K10), Perceived Stress Scale-10 (PSS), Impact of Event Scale Revised (IES-R), and Post-traumatic Growth Inventory (PTGI) and were clinically interviewed 1 and 6 months after discharge. Altered behavioral-psychological symptoms and patients' strategies (adaptive vs. maladaptive) for coping with stress during and after hospitalization were coded during clinical interviews. Between 20 and 30% of patients showed moderate symptoms of depression or anxiety and perceived stress 1 and 6 months after discharge. Sleep problems, difficulty concentrating, confusion in placing events, and fear of reinfection were observed in many (6-17%) patients. At 6 months, only 7% of patients showed PTSD symptoms, and 50% showed post-traumatic growth in the "appreciation of life" sub-scale. Finally, 32% of subjects were classified as "maladaptive coping patients," and 68% as "adaptive coping patients." Patients who adopted "adaptive" coping strategies showed significantly lower levels of anxious-depressive symptoms and perceived stress when compared to subjects with "maladaptive" strategies at both time points. Coping strategy had no effect on PTSD symptoms or post-traumatic growth at 6 months. These findings clarify the short- and long-term psychological effects of intensive care due to COVID-19 infection and demonstrate that patient characteristics, particularly strategies for coping with stress, seem to play a critical role in psychological outcomes.
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Affiliation(s)
- Valeria Carola
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Cristina Vincenzo
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Chiara Morale
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Pelli
- Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Monica Rocco
- Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Giampaolo Nicolais
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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Kluwe-Schiavon B, De Zorzi L, Meireles J, Leite J, Sequeira H, Carvalho S. The psychological impact of the COVID-19 pandemic in Portugal: The role of personality traits and emotion regulation strategies. PLoS One 2022; 17:e0269496. [PMID: 35714078 PMCID: PMC9205515 DOI: 10.1371/journal.pone.0269496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/22/2022] [Indexed: 11/21/2022] Open
Abstract
Recent evidence suggests that both personality traits (PT) and emotion regulation (ER) strategies play an important role in the way people cope with the COVID-19 pandemic. The aim of this study was two folded. First, to longitudinally investigate the psychological distress (depression, anxiety, and stress levels) taking in consideration PT and ER strategies in 3 different moments: during the first lockdown period (April/20), at the first deconfinement (May/20) and 1-month after the first deconfinement (Jun/20)-Experiment I. Second, to cross-sectionally evaluate the impact of the pandemic in psychological distress and the correlates with PT and ER 6-months after the first deconfinement November/20 to February/21 -Experiment II. A total of 722 volunteers (Experiment I = 180; Experiment II = 542) aged 18 years or older participated in this online survey. The findings from Experiment I show that psychological distress decreased after the lockdown period, however, neuroticism traits predicted higher levels of depression, anxiety and stress symptoms, while difficulties in ER strategies were identified as a risk factor for depression and stress. For experiment II, neuroticism traits and being infected with COVID-19 were associated to higher levels of symptomatology, while unemployment and the use of emotional suppression strategies to cope with emotional situations were associated to depressive and anxiety symptoms. Although the psychological impact of the COVID-19 outbreak decreased over time in our sample, the current findings suggest that difficulties in emotional regulation and high levels of neuroticism traits might be potential risk factors for psychiatric symptomatology during the COVID-19 pandemic. Thus, people with difficulties in ER and neuroticism traits would benefit from psychological interventions that provide personality-appropriate support and promote emotion regulation skills during stressful events, such as the case of the global pandemic.
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Affiliation(s)
- Bruno Kluwe-Schiavon
- Psychological Neuroscience Laboratory, The Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Lucas De Zorzi
- CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, University of Lille, Lille, France
| | - Joana Meireles
- Psychological Neuroscience Laboratory, The Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Jorge Leite
- Portucalense Institute for Human Development, INPP, Rua Dr. António Bernardino Almeida, Portucalense University, Porto, Portugal
| | - Henrique Sequeira
- CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, University of Lille, Lille, France
| | - Sandra Carvalho
- Psychological Neuroscience Laboratory, The Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
- Translational Neuropsichology Lab, Department of Education and Psychology, William James Center for Research, University of Aveiro, Aveiro, Portugal
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Shan Y, Ji M, Xie W, Li R, Qian X, Zhang X, Hao T. Interventions in Chinese Undergraduate Students' Mental Health: Systematic Review. Interact J Med Res 2022; 11:e38249. [PMID: 35704383 PMCID: PMC9244660 DOI: 10.2196/38249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/16/2022] [Accepted: 05/27/2022] [Indexed: 12/08/2022] Open
Abstract
BACKGROUND Over 30% of university students from 8 countries were afflicted with mental distress according to a World Health Organization survey. Undergraduate students in increasing numbers in China have also been reported to suffer from different mental problems. Various psychological distresses significantly impact their academic and daily life, thereby causing role impairments and unsatisfactory academic achievements. While the prevalence of, diverse underlying factors for, and interventions of social support in college students' mental health have extensively been investigated in China, there is no study exclusively focusing on the impact of interventions on their psychological well-being. OBJECTIVE The aim of this review was to identify and synthesize the interventions in the mental health concerns of Chinese undergraduate students studying in China reported in the literature to inform educational authorities, college and university management, students' affairs counselors, and mental health providers. METHODS We performed a systematic review and reported the research findings of previous studies according to the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. First, based on the predefined search strategy, keyword searches were performed in the PubMed and ProQuest databases to retrieve relevant studies. Subsequently, we screened the candidate articles based on predefined inclusion and exclusion criteria. Finally, we analyzed the included papers for qualitative synthesis. RESULTS We retrieved a total of 675 studies from the PubMed and ProQuest databases using the search strategy on March 15, 2022. Among these candidate studies, 15 that were not written in English, 76 duplicates, and 149 studies of other document types were removed before screening. An additional 313 studies were excluded in the screening process, with 73 articles ruled out for being not relevant to interventions, not related to mental health, or not focused on undergraduate students in the full-text review. As a result, 49 papers were eligible and included in this systematic review. In the qualitative synthesis, we divided the interventions reported in the selected studies into two categories: (1) social support from government authorities, university authorities, students' affairs counselors and teachers, family members, health care authorities and professionals, and the media (various online platforms), and (2) various coping strategies adopted by undergraduate students themselves. We identified further research on mental health interventions that may be delivered by digital medical platforms, conversational agents (eg, chatbots), and researchers. CONCLUSIONS This was the first systematic review of interventions to address the mental health concerns of Chinese undergraduate students studying in China. The categorization of reported interventions and the identification of new intervention channels can effectively inform stakeholders. Interventions for undergraduate students' mental health is a research topic worth further investigation.
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Affiliation(s)
- Yi Shan
- School of Foreign Studies, Nantong University, Nantong, China
| | - Meng Ji
- School of Languages and Cultures, University of Sydney, Sydney, Australia
| | - Wenxiu Xie
- Department of Computer Science, City University of Hong Kong, Hong Kong, China
| | - Rongying Li
- School of Artificial Intelligence, South China Normal University, Guangzhou, China
| | - Xiaobo Qian
- School of Computer Science, South China Normal University, Guangzhou, China
| | - Xiaomin Zhang
- Department of Linguistics, Macquarie University, Sydney, Australia
| | - Tianyong Hao
- School of Computer Science, South China Normal University, Guangzhou, China
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15
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Do Specific Craniomaxillofacial Features Correlate with Psychological Distress in Adult Pretreatment Orthodontic Patients? A Cephalometric Study. DISEASE MARKERS 2022; 2022:9694413. [PMID: 35571617 PMCID: PMC9098301 DOI: 10.1155/2022/9694413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 02/05/2023]
Abstract
Purpose To explore the relationship between craniomaxillofacial features and psychological distress among adult pretreatment orthodontic patients. Methods A group of 190 patients (95 males and 95 females) was included. Questionnaires including the Kessler psychological distress scale (K10) were sent to patients, and cephalograms were collected. Patients were divided into two groups according to K10 score: psychological distress group (score ≥ 20) and no psychological distress group (score < 20). Nineteen hard tissue and thirteen soft tissue parameters were traced on cephalograms to characterize the craniomaxillofacial features. Results There was no significant difference in gender or age distribution between the two groups. Male patients with psychological distress showed statistically significantly larger anterior facial height (AFH) (126.62 mm vs. 120.97 mm), upper lip length (25.11 mm vs. 23.26 mm), and smaller overbite (1.21 mm vs. 2.75 mm) than patients without psychological distress. Male patients with hyperdivergent pattern and open bite were more likely to have psychological distress. None of the parameters showed statistical differences across groups in females. Frankfort-mandibular plane angle (r = 0.235), Bjork's sum (r = 0.311), AFH (r = 0.322), overbite (r = −0.238), AFH/posterior facial height (r = 0.251), and upper anterior facial height (UAFH)/lower anterior facial height (LAFH) (r = −0.230) were correlated with K10 score in males. After adjusting gender and age, the AFH (B = 0.147) and UAFH/LAFH (B = −14.923) were significantly related with the K10 score. Conclusion Psychological distress was mainly correlated with hyperdivergent pattern, open bite, and larger lower anterior facial height proportion in pretreatment orthodontic patients. Orthodontists should be aware of the possible underlying psychological distress in patients with specific craniomaxillofacial features. Clinical assessment of psychological distress may need to take into account gender differences in patients.
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16
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Impact of Self-Perceived Employability on Sustainable Career Development in Times of COVID-19: Two Mediating Paths. SUSTAINABILITY 2022. [DOI: 10.3390/su14073753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The outbreak of COVID-19 added further stress to individuals’ work life, and employability may be especially important to help individuals to pursue sustainable career success in such a context. However, previous studies that examined the impact and the mechanisms of employability on sustainable career success are lacking, especially in the context of pandemic threat. Based on conservation of resource theory (COR), the current study aims to explore whether and how employability, as an important resource, reduced work-related emotional exhaustion and increased work engagement during the COVID-19 pandemic. We expected that self-perceived employability would reduce emotional exhaustion and increase work engagement. We further expected that coping strategy mediated the effect of self-perceived employability on emotional exhaustion, and career commitment mediated its effect on work engagement. Data were collected via a national survey in China among a sample of 4990 human resource practitioners from October to December 2020 amid the COVID-19 outbreak. The proposed model was tested with structural equation modelling. Results supported the proposed model. Self-perceived employability reduced emotional exhaustion and to a larger extent, increases work engagement. The two mediating effects were of partial mediation. The implications of the results for theory and practice are discussed.
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Stanyte A, Podlipskyte A, Milasauskiene E, Király O, Demetrovics Z, Ambrasas L, Burkauskas J, Steibliene V. Mental Health and Wellbeing in Lithuanian Medical Students and Resident Doctors During COVID-19 Pandemic. Front Psychiatry 2022; 13:871137. [PMID: 35573339 PMCID: PMC9092277 DOI: 10.3389/fpsyt.2022.871137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had a negative effect on mental health and subjective psychological wellbeing. One of the most affected population is medical students, reporting higher levels of depression, anxiety, sleep difficulties, and overall poorer wellbeing. However, the relationship between depression, anxiety, and sleep difficulties, and subjective psychological wellbeing has not been extensively researched in medical students in the context of COVID-19 pandemic. The aim of this study was to investigate the associations between depression, anxiety, and sleep quality, and subjective psychological wellbeing. METHODS In total, 524 medical students and resident doctors (78.6% female, mean age 24 ± 3 years old) participated in an online survey between December 2020 and February 2021. Participants completed the WHO-Five Wellbeing Index Questionnaire, the Pittsburgh Sleep Quality Index questionnaire, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder Assessment-7. RESULTS Multivariable logistic regression analysis showed that female participants' worse subjective psychological wellbeing was associated with sleep difficulties [odds ratio (OR) = 2.39, 95% CI = 1.37-4.18, p = 0.002], higher depression (OR = 6.13, 95% CI = 3.46-10.88, p < 0.001), and anxiety symptoms (OR = 2.95, 95% CI = 1.66-5.22, p < 0.001). In male participants, analysis revealed an association between worse subjective psychological wellbeing and higher depression scores (OR = 9.94, 95% CI = 3.29-30.03, p < 0.001). CONCLUSION Sex differences are an important factor to consider when evaluating subjective psychological wellbeing. Clinicians should be aware of significant contributors, such as sleep patterns anxiety, and depression, to subjective psychological wellbeing.
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Affiliation(s)
- Agne Stanyte
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Aurelija Podlipskyte
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Egle Milasauskiene
- Clinic of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Laurynas Ambrasas
- Clinic of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Vesta Steibliene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.,Clinic of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Alshammari S, Alotaibi R, Almajed A, Omar T. Depression, anxiety, and stress among the community during COVID-19 lockdown in Saudi Arabia. JOURNAL OF NATURE AND SCIENCE OF MEDICINE 2022. [DOI: 10.4103/jnsm.jnsm_62_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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