The psychological impact of the COVID-19 epidemic on college students in China

Who still suffers? Effects of COVID-19 stressful experiences on somatic symptoms and anxious mood moderated by diurnal cortisol: A daily diary study

This daily diary study drew on the allostatic load model to examine the predictive effect of COVID-19 stressful experiences (CSE) on somatic symptoms and anxious mood, as well as applying the biological sensitivity to context model to explore whether diurnal cortisol moderated the above associations. A total of 101 Chinese college students retrospectively reported CSE in October 2020, followed by 5-day diary reports on somatic symptoms and anxious mood in November 2020, with salivary cortisol collected on Days 2 to 4 to measure cortisol awakening response (CAR), diurnal cortisol slope (DCS), and daily cortisol output (area under the curve with respect to ground, AUCg). Results of multilevel models showed that greater CSE predicted more somatic symptoms but not anxious mood, which was only observed at flatter CAR, flatter DCS, or low AUCg. Furthermore, three-way interactions of CSE, CAR, and AUCg significantly predicted both somatic symptoms and anxious mood. Specifically, greater CSE predicted more somatic symptoms at flatter CAR with low AUCg, while predicting higher anxious mood at flatter CAR with high AUCg. Our findings demonstrate the long-term consequences following the prior pandemic, especially highlighting the biological vulnerability related to the synergetic effects of diurnal cortisol rhythms and daily cortisol output.

Relationship between perceived social support and stoma self-efficacy in permanent colostomy patients: A correlational study

AIM

In the context of adjusting to life with a permanent colostomy, this study explored how perceived social support from family, friends and others influences patients' self-efficacy in managing their stoma and engaging with their social lives.

METHODS

The study employed a descriptive, correlational design to investigate the relationship between social support and self-efficacy in 94 colostomy patients between April 2021 and August 2022. Participants completed the Descriptive Characteristics Form, Multidimensional Scale of Perceived Social Support (MSPSS), and stoma self-efficacy scale (SSES). Descriptive statistics were used to summarise the data, and one-way ANOVA with Tukey HSD post-hoc test examined group differences. Pearson correlation assessed the relationship between age, social support and self-efficacy, while multiple linear regression identified factors independently associated with self-efficacy level.

RESULTS

The participants had a mean age of 56.9 ± 14.34 years, and 37.2% had been suffering from stoma complications for a duration ranging from 13 months to 5 years. The mean total score on the MSPSS was 64.3 ± 13.5, whereas the mean total score on the SSES stood at 71.22 ± 20.21. A moderate positive correlation (r = 0.419, p < 0.001) was observed between the total scores from the MSPSS and SSES. The increase in the total score on the MSPSS was a significant predictor (β = 0.293, p = 0.001) of the level of stoma self-efficacy, explaining 48.9% of the variance.

CONCLUSION

Stronger perceived social support was linked to higher stoma self-efficacy in permanent colostomy patients.

The associations between emotional empathy, emotional intelligence, and COVID-19-related stress among nursing students: a cross-sectional study

BACKGROUND

The COVID-19 pandemic has variably affected the stress levels among students. Nursing students, as the reserve force of medical resources and the successors of frontline nursing staff, warrant particular attention regarding their stress levels. This study investigates the relationship between emotional empathy, emotional intelligence, and COVID-19-related stress in nursing students and examines the masking role of emotional intelligence in this relationship.

METHODS

A cross-sectional study was conducted from March to June 2023 using multi-stage sampling method to recruit 1126 nursing students from a medical university. Participants completed a demographic information questionnaire, the COVID-19 Student Stress Questionnaire, the Multidimensional Emotional Empathy Scale, and the Trait Meta-Mood Scale. Data were analyzed using t-tests/ one-way ANOVA, Pearson correlations, multiple linear regression, and the PROCESS macro program to examine the relationships between emotional empathy, emotional intelligence, and COVID-19-related stress, as well as the masking role of emotional intelligence.

RESULTS

Statistically significant differences were observed in COVID-19-related stress scores among nursing students from different residential areas (P < 0.05); Emotional empathy was significantly positively correlated with emotional intelligence and its dimensions. Emotional empathy also showed a significant positive correlation with COVID-19-related stress. Emotional intelligence and its dimensions were significantly negatively correlated with COVID-19-related stress; Emotional empathy and emotional intelligence were significant predictors of COVID-19-related stress; Emotional intelligence and its dimensions demonstrated a masking effect on the relationship between emotional empathy and COVID-19-related stress, with total effect sizes of -0.023 for emotional intelligence, -0.021 for emotional attention, -0.017 for emotional clarity, and - 0.018 for emotional repair.

CONCLUSION

Emotional empathy and emotional intelligence were significant predictors of COVID-19-related stress among nursing students. Emotional intelligence masked the impact of emotional empathy on COVID-19-related stress. Schools should implement stress management programs for nursing students that focus on enhancing emotional intelligence and moderating excessive emotional empathy. These programs are particularly crucial during public health emergencies to reduce stress levels and promote mental well-being.

CLINICAL TRIAL NUMBER

Not applicable.

The prevalence of 12-month suicidal ideation and associated factors among university students in China: Findings from a three-wave cross-sectional study from 2021 to 2023

BACKGROUND

Many studies have shown that the COVID-19 pandemic has increased the risk of suicidal tendencies among the public. However, there is limited research reporting on the changing trends in suicidal ideation after 2020 in the context of the long-term normalization of COVID-19 prevention and control measures in China.

METHODS

The self-administered online questionnaire was adopted to collect 12-month suicidal ideation, depressive symptoms, anxiety symptoms, stress, and some demographic information from university students by convenient cluster sampling in Shandong, Shaanxi, and Jilin Provinces, China. Multivariate logistic regressions were performed to assess the association between different factors and suicidal ideation.

RESULTS

The prevalence of 12-month suicidal ideation from 2021 to 2023 among university students was 3.89 %, 5.81 %, and 4.33 %, respectively, showing a trend of first increasing and then decreasing. The trends presented a similar tendency in the subgroups according to gender, majors, and grades, except among urban freshman-year students. The associated factors of suicidal ideation were different among university students in different surveys. However, female gender, poor mental health, and depressive symptoms were linked to a higher risk of suicidal ideation.

LIMITATIONS

More representative large-scale longitudinal studies should be used to monitor the suicidal behavior of university students.

CONCLUSIONS

The prevalence of 12-month suicidal ideation among Chinese university students exhibited a pattern of initial increase followed by a subsequent decrease from 2021 to 2023. Despite the complete lifting of COVID-19 prevention and control measures in China, the prolonged three-year epidemic may have enduring adverse effects on university students, underscoring the ongoing importance of providing continuous mental health services to this population.

Chronic impacts of natural infrastructure on the physical and psychological health of university students during and after COVID-19: a case study of Chengdu, China

Introduction

The COVID-19 pandemic has underscored the health benefits of green spaces, yet research on how specific elements of natural infrastructure affect well-being during the pandemic has been limited.

Methods

This study, conducted at Sichuan Agricultural University with 300 students in 2022, investigated how urban natural infrastructure impacts physical and psychological well-being during the pandemic. Different aspects of natural infrastructure, such as thermal comfort, air quality (negative ion concentration), and noise and light levels, varied in their positive effects on students' health.

Results

The findings revealed that 65.6% of university students felt reduced stress when engaging with outdoor spaces, and 72.8% of them renewed recognized the therapeutic value of nature.

Discussion

The study emphasizes the importance of incorporating natural elements into urban planning to enhance outdoor activity and well-being, especially in post-pandemic settings. Recommendations are provided for future urban design to address the therapeutic needs of specific populations.

Prevalence of Internet Gaming Disorder, Depression, and Anxiety Symptoms Before and After the Pandemic

"Internet gaming disorder" (IGD) is a condition for further study in the DSM-5, with its prevalence estimated to be anywhere from 0.7% to 27.5% depending on the methodology used to measure it. Previous research has linked the symptoms of IGD to symptoms of depression and anxiety among college students. Methods: The current study explored the relationships between self-reported symptoms of IGD, depression, and anxiety in two small, non-overlapping samples of college students, one collected before the pandemic (n = 52) and another during the global pandemic (n = 89). Data on the time spent gaming, IGD, depression, and anxiety symptoms were collected via anonymous online surveys at a small Mid-Western liberal arts university. The samples differed significantly in age, likely due to the smaller incoming first-year class size as a result of many families deciding to defer the start of college in 2020. Conclusions: These findings partially support past research suggesting a small to moderate association between self-reports of IGD and depression symptoms. While the pandemic does not appear to have greatly changed the overall number of self-reported symptoms experienced or the time spent playing video games between the two samples, it may have exacerbated the relationship between these variables within the sample. The stronger relationship between symptoms of depression or anxiety and the time spent playing video games in the later sample may be particularly concerning if the trend continues, as it may lead to additional problematic gaming behavior in the future.

Interest in healthcare work post-pandemic: A study on social work students' perspectives

This study explored social work students' attitudes toward healthcare responsibilities after the Coronavirus Disease 2019 (COVID-19) pandemic. Surveying n = 184 third and fourth-year Social Work students revealed a generally negative attitude toward working in healthcare. Factors such as age, marital status, academic level, personal or familial virus infection history, COVID-19 vaccination status, presence of chronic illness, or experiencing a COVID-19-related death did not significantly influence these attitudes. The challenges faced in healthcare during the pandemic, including psychological and physiological impacts, underscore the importance of equipping Social Work students with the necessary knowledge and skills for future healthcare roles. This research suggests that addressing students' concerns and competencies in Social Work curricula may positively influence their future healthcare field engagement.

Blame others but hurt yourself: blaming or sympathetic attitudes toward victims of COVID-19 and how it alters one's health status

OBJECTIVE

This study explored the relationship between blame/sympathy and blamer's/sympathizer's perceived health status.

DESIGN

We recruited participants via an online survey platform. Study 1 was a cross-sectional study using data (N = 3304, Mage = 28.22, SDage = 7.92, and 39.3% female) collected from 30 provinces, municipalities, and autonomous regions of China on February 3, 2020. Study 2 used the daily diary method collecting data from February 4 to 9, 2020. Sample (N = 2456, Mage = 28.49, SDage = 7.49, and 39.4% were female) was obtained by inviting participants in Study 1 on the same platform.

MAIN OUTCOME MEASURES

Self-reported health status and life satisfaction.

RESULTS

In Study 1, blame was negatively associated with perceived health status, while sympathy was positively associated with it. Negative emotions and risk perception are the underlying mechanisms, but neither of them has effects on the relationship between sympathy and perceived health status. Study 2 replicated these results using multilevel analysis.

CONCLUSION

The results highlight the importance of people's attitudes on perceived health status. While sympathy is positively related to perceived health status, blaming has a negative association with perceived health status. Negative emotions and risk perceptions are the underlying mechanisms.

Investigating mental health outcomes of undergraduates and graduate students in Taiwan during the COVID-19 pandemic

Objective: This study is an exploration of the major stressors associated with the COVID-19 for students in higher education in Taiwan. Participants: The sample comprised 838 higher education students studying at various Taiwanese universities. Methods: A cross-sectional online survey was administered at different postsecondary institutions during the semi-lockdown period of COVID-19, which mandated online instruction. Machine learning was employed to determine the variables that most highly predicted students' mental health using R. Results: The findings revealed that COVID-19-related experiences, including social interactions, financial conditions, and educational experiences, were significantly associated with mental health outcomes. Particularly, loneliness are significantly related to social interactions and educational experiences. Conclusions: Findings revealed that Covid-19 impacted Taiwanese students' financial conditions, educational experiences, and social interactions, which were significant predictors of their mental health outcomes such as anxiety, loneliness and depression. The current study contributes to the gap in knowledge about mental health issues among postsecondary students during the pandemic.

Stacked artificial neural network to predict the mental illness during the COVID-19 pandemic

The individual's mental health crisis and the COVID-19 pandemic lead to mental disorders. The transmission of the COVID-19 virus is associated with the levels of anxiety, stress, and depression in individuals, similar to other factors. Increases in mental illness cases and the prevalence of depression have peaked after the pandemic struck. The limited social intervention, reduced communication, peer support, and increased social isolation during the pandemic resulted in higher levels of depression, stress, and anxiety which leads to mental illness. Physiological distress is associated with the mental disorders, and its negative impact can be improved mainly by early detection and treatment. Early identification of mental illness is crucial for timely intervention to decelerate disorder severity and lessen individual health burdens. Laboratory tests for diagnosing mental illness depend on the self-reports of one's mental status, but it is labor intensive and time consuming. Traditional methods like linear or nonlinear regression cannot include many explanatory variables as they are prone to overfitting. The main challenge of the state-of-the-art models is the poor performance in detecting mental illnesses at early stages. Deep learning models can handle numerous variables. The current study focuses on demographic background, Kessler Psychological Distress, Happiness, and Health determinants of mental health during the pandemic to predict the mental health. This study's prediction can help rapid diagnosis and treatment and promote overall public mental health. Despite potential response bias, these proportions are exceptionally elevated, and it's plausible that certain individuals face an even higher level of risk. In the context of the COVID-19 pandemic, an investigation into mental health patients revealed a disproportionate representation of children and individuals with neurotic disorders among those articulating substantial or severe apprehensions.

Online Media Consumption, Fear, Mental Wellbeing, and Behavioral Compliance During the COVID-19 Pandemic: A Longitudinal Study

This study explored how online media consumption, fear, mental wellbeing, and behavioral compliance with COVID-19 measures were related to one another during the COVID-19 pandemic. Employing a four-wave longitudinal survey research design (n = 1,092), this study found positive relationships between online media consumption and fear of COVID-19, between fear of COVID-19 and behavioral compliance, and between behavioral compliance and mental wellbeing in the general Dutch population. Results showed a negative relationship between fear of COVID-19 and mental wellbeing. Repeated measures ANOVAs indicated that participants' online media consumption, fear of COVID-19, and behavioral compliance with COVID-19 measures all gradually decreased as the pandemic progressed, while mental wellbeing gradually recovered as the pandemic progressed. Recognizing the negative relationship between fear of COVID-19 and mental wellbeing, policymakers may be encouraged to focus on implementing interventions and communication strategies to support mental health during pandemics. Using other types of appeals (e.g. hope appeals) in addition to the commonly used fear appeals when developing online public health messages could ensure behavioral compliance during pandemics without triggering high levels of fear. This can contribute to maintaining people's mental wellbeing when they have to cope with life-threatening public health crises while still promoting behavioral compliance with necessary public health measures.

Psychological health benefits of focusing on the 'here and now' versus a limited future during the COVID-19 pandemic

Objective: College students' psychological health has been negatively impacted by the COVID-19 pandemic (e.g., 1). We investigated whether students' psychological health was related to their orientation toward the future and mindfulness while considering previously-identified correlates of psychological health such as perceived risks of COVID-19. Participants: Participants were 278 college students at a mid-Atlantic US university in November and December 2020. Method: Using a self-report survey, we measured three aspects of psychological health (depression, anxiety, and stress) and future orientation, mindfulness, perceptions of risk, and the personal impact of COVID-19 on students' lives. Results: Multiple linear regression analyses showed that greater mindfulness and focusing less on a limited future were related to less depression, anxiety, and stress. Conclusions: Encouraging students to be mindful and focus on the present instead of focusing on a limited future may be beneficial for their psychological well-being during the COVID-19 pandemic.

Substance Use and Mental Health in Emerging Adult University Students Before, During, and After the COVID-19 Pandemic in Mexico: A Comparative Study

BACKGROUND

The COVID-19 pandemic significantly impacted mental health and substance use patterns, particularly among young adults.

OBJECTIVE

This study aimed to assess changes in anxiety, depression, self-esteem, and substance use among university students in Mexico before, during, and after the pandemic.

METHODS

Using a repeated cross-sectional design, this study was conducted with university students in Mexico across three periods: pre-pandemic (2017 and 2019); during the pandemic (2021); and post-pandemic (2023). A total of 2167 students were interviewed during one of the three periods. Standardized scales measured anxiety, depression, self-esteem, Erotic Response and Sexual Orientation Scale (EROS), and substance use.

RESULTS

showed a marked and significant increase in the proportion of students with anxiety (40.0%, 71.7%, and 79.6%) and depression (14.4%, 61.9%, and 62.6%) during the pre-pandemic, pandemic, and post-pandemic periods, respectively. Self-esteem significantly decreased during and after the pandemic, compared to pre-pandemic, particularly among females. The proportion of students categorized as moderate/high-risk for their substance use changed over time, showing a reduction in alcohol use (from 29.9% to 20.2%) and tobacco use (from 26.0% to 18.2%) but an increase in sedative use (from 7.1% to 11.7%), before vs after the pandemic, respectively. Multivariate analysis revealed that anxiety, low self-esteem, and increased sedative use were consistently linked to a heightened risk of depression during and after the pandemic. Notably, anxiety and depression levels remained in a proportion significantly elevated even in the post-pandemic period.

CONCLUSIONS

These findings underscore the enduring impact of the COVID-19 pandemic on the mental health of university students, highlighting the urgent need for targeted interventions, early detection strategies, and customized educational programs to effectively support students' mental well-being in the ongoing post-pandemic era.

Impact of pandemic-related worries on mental health in India from 2020 to 2022

This study examines how pandemic-related worries affected mental health in India's adults from 2020 to 2022. Using data from the Global COVID-19 Trends and Impact Survey (N = 2,576,174), it explores the associations between worry variables (financial stress, food insecurity, and COVID-19-related health worries) and self-reported symptoms of depression and anxiety. Our analysis, based on complete cases (N = 747,996), used survey-weighted models, adjusting for demographics and calendar time. The study finds significant associations between these worries and mental health outcomes, with financial stress being the most significant factor affecting both depression (adjusted odds ratio, aOR: 2.36; 95% confidence interval, CI: [2.27, 2.46]) and anxiety (aOR: 1.91; 95% CI: [1.81, 2.01])). Models with interaction terms revealed gender, residential status, and calendar time as effect modifiers. This study demonstrates that social media platforms like Facebook can effectively gather large-scale survey data to track mental health trends during public health crises.

Evolving Trends in College Students' Health Education: A Bibliometric Analysis

This study offers new insights into college students' health education (CSHE) regarding its research status, hot spots, and trends by conducting a comprehensive bibliometric analysis of this field in the past decade (2014 to 2024). Specifically, we analyzed publication trends and used the bibliometric method with CiteSpace software to explore collaborative networks, detailed co-citation status, and co-occurrence dynamics based on 1358 Web of Science Core Collection articles. Our results indicate increased relevant publications and the collaboration networks show complex institutional and regional partnerships. At the same time, co-citation and co-occurrence analyses highlight interdisciplinary research themes that encompass public health. The study particularly underscores the emerging importance of mental health, global health, and innovative educational approaches. These findings reveal trends in CSHE research and provide crucial insights for future studies, stressing the need for interdisciplinary collaboration and creative strategies to tackle student health challenges. Moreover, in practice, this study contributes to promoting and practicing targeted health intervention policies and countermeasures aimed at enhancing student well-being, such as establishing dedicated health education courses, providing specialized training for teachers, conducting regular health assessments, and providing funding for CSHE.

Addressing psychological resilience and its determinants among university students during the COVID-19 pandemic: a three-wave longitudinal study in Shandong Province, China

BACKGROUND

The relationship between public health emergencies and psychological distress had been well known, yet none research had been conducted on the trend in psychological resilience and its longitudinal determinants during the pandemic. This study aimed to explore the changes of psychological resilience of university students during COVID-19 pandemic, and further clarify the longitudinal relationship between family factors, mental health, social mentality and psychological resilience.

METHODS

Questionnaires were distributed to students from five universities in Shandong Province, China during the COVID-19. A total of 1635 students were finally included in this three-wave follow-up study using stratified random sampling method. Mental health was assessed by Depression Anxiety Stress Scale, social mentality was measured by the Bi-Dimensional Structure Questionnaire of Social Mentality, psychological resilience was evaluated by the Chinese version of the Psychological Resilience Scale. Repeated-measures analysis of variance was used to analyze the longitudinal changes of psychological resilience, generalized estimating equation (GEE) was conducted to estimate the determinants of psychological resilience.

RESULTS

Psychological resilience changed from 28.37 in Wave 1, 29.10 in Wave 2, and 29.15 in Wave 3 among the university students. The students who majored in Art (β = 0.872, P = 0.032), parents (mother β = 0.546, P = 0.035; father β = 0.718, P = 0.012) had a greater influence on children's personality, and positive social mentality (β = 5.725, P < 0.001) were more likely to report a higher psychological resilience. Being female (β=-0.932, P < 0.001), not being a student leader (β=-0.911, P < 0.001), being anxious (β=-1.845, P < 0.001) and depressed (β=-1.846, P < 0.001), and negative social mentality (β=-0.803, P < 0.001) were less likely to report a higher psychological resilience.

CONCLUSIONS

The psychological resilience of the university students in Shandong Province, China increased significantly from Wave 1 to Wave 3 during the COVID-19 pandemic. Majoring in Art, parents having a greater influence on children's personality, better mental health, positive social mentality were more likely to report a higher psychological resilience, while female, not student leader, worse mental health, and negative social mentality were less likely to report a higher the psychological resilience.

Prevalence and Correlates of Likely Anxiety Disorder in Ghana During the COVID-19 Pandemic: Evidence From a Cross-Sectional Online Survey

BACKGROUND

The COVID-19 pandemic created stressors to daily living, leading to increased mental health problems. It is important to assess the influence of COVID-19 pandemic on mental health, specifically anxiety.

OBJECTIVES

The goal was to determine the prevalence and sociodemographic, clinical, and other correlates of likely Generalized Anxiety Disorder (GAD) among study subjects in Ghana.

DESIGN

This study employed a cross-sectional approach, using an online survey administered primarily through social media platforms. The survey questions included the GAD-7 scale, which was used to assess likely GAD in respondents. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression analysis.

PARTICIPANTS

Overall, 756 respondents completed the survey, mainly from Ashanti and Greater Accra, which were the hardest hit by COVID-19.

RESULTS

The prevalence of likely GAD in our sample was 7.6%. Gender, loss of job due to COVID-19, and seeking mental health counseling were independently associated with increased likelihood of GAD.

CONCLUSIONS

The findings suggest that women, those who lost their jobs due to the COVID-19 pandemic, and those who sought mental health counseling were more likely to experience moderate to high anxiety symptoms as a result of the COVID-19 pandemic. Priority must be attached to psychological support measures for members of these groups.

Depression, anxiety, and help-seeking among Slovenian postsecondary students during the COVID-19 pandemic

Introduction

The COVID-19 pandemic has faced students with many challenges, contributing to their mental distress. This article explores the role of demographic characteristics, psychological status, year of study, and social support during the COVID-19 pandemic in explaining Slovenian university students' mental health problems and help-seeking behavior.

Methods

In February and March 2021, data were collected on 5,234 full-time Slovenian postsecondary students who were enrolled in public and concessionary independent higher education institutions. Participants completed a questionnaire, which included The Patient Health Questionnaire (PHQ-9), General Anxiety Disorder questionnaire (GAD-7), Oslo Social Support Scale (OSSS-3), and items measuring psychological status, help-seeking behavior and demographics. Data were analyzed using multiple linear regression and hypothesis testing for differences.

Results

Factors, such as gender, age, psychological status and social support, contributed to experiencing anxiety and depression among Slovenian students during the COVID-19 pandemic, with year of study additionally contributing to experiencing depression. Similarly, gender, age, psychological status and social support contributed to help-seeking behavior. Higher levels of depression and anxiety were reported by female students, students with prior mental disorders, and students with lower social support levels. Female students and students with lower social support levels reported more frequent help-seeking behaviors.

Conclusion

The results provide insight into the mental state of the Slovenian student population in the context of imposed public health measures at the end of the second COVID-19 wave in Slovenia. The findings can help identify vulnerable groups within the student population to whom we must be particularly attentive in times of crisis.

Social isolation, psychological distress and resilience of Chinese college students during COVID-19 pandemic

It has been 3 years since the first appearance of COVID-19 in China. During this time, social isolation was widely used as an important method to fight it. However, this measure had many negative effects on the mental health of college students. To better understand this issue, this study aims to explore the impact of social isolation and COVID-19-related stress on psychological distress among Chinese college students. Additionally, resilience has been evaluated as a key component of stress resistance in this situation. Coronavirus Stress Measure (CSM), the Connor-Davidson Resilience Scale (CD-RISC) and the Brief Symptom Inventory (BSI) were used in this study. A total of 388 Chinese college students participated in the survey via the Internet. Two groups (isolated group vs. non-isolated group) were divided according to whether they have been isolated from their classmates and families. Data analysis adopts t-test, F test and mediate effect analysis by SPSS21.0. (1) All factors, except resilience, were found to have lower scores in the isolated group; (2) significant correlations were found between all factors; (3) resilience partially mitigated the impact of COVID-19 stress on psychological symptoms. Social isolation has been found to be a significant factor contributing to negative psychological distress in Chinese college students. The COVID-19-related stress may increase the likelihood of psychological suffering among isolated group. Resilience can help reduce the negative effects of COVID-19 stress on college students. Therefore, providing appropriate psychological support tailored to different isolation situations is crucial.

Understanding psychological symptoms among Chinese college students during the COVID-19 Omicron pandemic: Findings from a national cross-sectional survey in 2023

During the Omicron pandemic in late 2022, this study surveyed Chinese students via an online questionnaire to assess their mental health status, prevalence of psychological symptoms, and associated factors. A nationwide cross-sectional survey of 4254 participants was conducted in seven regions of China from January 5 to February 9, 2023. Scales were utilized respectively to measure depressive symptoms, anxiety symptoms, post-traumatic stress disorder (PTSD) symptoms, and perceived social support. Descriptive, univariate, and multivariable analyses were performed to identify associated factors. Protective factors against depressive symptoms include regular exercise and robust social support networks, while risk factors involve excessive alcohol consumption, comorbidities, Omicron infection, and irregular sleep patterns. Risk factors for anxiety symptoms include comorbidities, Omicron infection, living alone, and irregular sleep patterns, while social support emerges as a protective factor. For PTSD symptoms, regular exercise and strong social support systems are identified as protective measures, with risks associated with comorbidities, Omicron infection, and poor sleep quality. Students are particularly vulnerable during the pandemic due to their lifestyle and academic pressures. It's essential to bolster their social support and promote healthier habits.

Concerns of osteopathic medical students during the COVID-19 pandemic

OBJECTIVES

This study aims to quantify the areas of most concern in medical students in relation to their residency application in the setting of the COVID-19 pandemic and to identify risk factors for all that cause concern and specific areas of concern in a population with well-established high rates of anxiety at baseline. The COVID-19 pandemic introduced sweeping changes to medical education that had wide-ranging effects on medical students and their applications for medical residencies.

METHODS

In August 2020, we utilized a cross-sectional study to quantify student's areas of concern related to residency application related to the COVID-19 pandemic. We asked participants to rate their levels of concern in 15 different aspects related to medical residency applications and the perceived impact that COVID-19 had on each.

RESULTS

The survey was distributed to 984 osteopathic medical students, with 255 complete responses. The three areas of greatest impact were shadowing opportunities (4.15), volunteer opportunities (4.09), and conferencing opportunities (4.09). The most salient demographic variables were year in school, sex, and locale. Females reported higher levels of concern across all categories in the study compared to males, with statistical significance across all categories (all p<0.05, Range d=0.16 to 0.43), except for letters of recommendation and sub-internships.

CONCLUSIONS

The areas of most concern identified in our study were consistent with prior studies and may implicate the pressures that female medical students may feel compared to their male counterparts. The underlying cause(s) may be subject to future research.

Prevalence of anhedonia, anxiety, and their impact on food consumption among postgraduate Qassim University students

Objectives

A prevalent symptom of many mental health issues, such as depression, is anhedonia, which is the inability to feel joy or pleasure. Tension-induced sensations, anxious thoughts, and bodily alterations are the hallmarks of anxiety. One known environmental factor that affects mental health is diet. In this implication, eating appetizing meals has been proposed to reduce unpleasant feelings like worry. This study aimed to indicate whether eating habits among postgraduate students are related to symptoms of anhedonia and/or anxiety.

Methods

In a cross-sectional study, responses were collected from a total of 393 postgraduate students. Each student self-answered the General Anxiety Disorder-7, Snaith-Hamilton Pleasure Scale for Anhedonia, and the Food Consumption Questionnaire and reported the body weight.

Results

The prevalence of anhedonia was 28%, moderate anxiety and severe anxiety were 15.7 and 10.9%, respectively. In this research, results showed that sugary foods, fast food, and fried foods were positively associated with anxiety and anhedonia. However, fruits and vegetables were negatively associated with anxiety and anhedonia. Linear regression showed that fruit and drinking water consumption was significant with the number of meals/day. There was no significance between the number of meals per day and anhedonia; however, there was statistical significance with the total GAD-7 scale score regarding the number of meals/per day.

Conclusion

Anhedonia and anxiety are associated with food consumption, especially foods rich in sugars, fast and fried, which help to increase positive feelings. Future studies should focus on understanding the relationship between food consumption and following a healthy diet and improving and reducing symptoms of anxiety and anhedonia in those who suffer from a stressful or task-filled lifestyle, such as students, especially postgraduate students. In addition, it focuses on the importance of awareness of the symptoms of anhedonia, which is classified as a depressive disease, and how to control anxiety to maintain better mental health.

Mask wearing and self-harming thoughts among international students in the United States during COVID-19: The moderating role of discrimination

Objective: This study examined associations among discrimination, mask-wearing behavior, and self-harming thoughts among international students in the United States during COVID-19. Participants: Undergraduate and graduate international students enrolled in universities during the 2020 summer semester participated in the online survey (N = 103). Methods: Perceived discrimination, mask-wearing behavior, and self-harming thoughts during COVID-19 were assessed by self-reports. Multivariable logistic regressions examined the association among discrimination, mask-wearing behavior, and self-harming thoughts and explored the potential moderation effect of discrimination on the association between mask-wearing and self-harming thoughts. Results: 18.6% of participants reported self-harming thoughts. Increased discrimination was significantly associated with increased odds of self-harming thoughts. Discrimination significantly moderated the association between mask wearing and self-harming thoughts. Conclusions: The findings highlight the importance of increased availability of culturally appropriate mental health services for international students and the need for increased advocacy to decrease discrimination against international students in the current societal context.

Parent and Young Adult Perspectives About the Transition to College During the COVID-19 Pandemic

PURPOSE

The purpose of this study was to describe the influence of COVID-19 on parents and their young adults with type 1 diabetes as they navigated the college environment during the COVID-19 pandemic.

PARTICIPANTS

A sample of 9 college students with type 1 diabetes and their parents were recruited to participate in interviews via purposive sampling methodology.

METHODS

A descriptive, qualitative study was conducted using semi-structured questions via recorded video conferencing interviews.

RESULTS

Three themes related to navigating type 1 diabetes at college during the pandemic emerged: (1) isolation and mental health: COVID-19-related isolation and loneliness; (2) risk and exposure to COVID-19: balancing risk of COVID-19 with type 1 diabetes; and (3) management of type 1 diabetes on campus during the pandemic: academics, university policies, and their impact on type 1 diabetes.

CONCLUSIONS

Students with type 1 diabetes and their parents had to navigate a complex set of concerns that extended beyond the usual challenges of diabetes management during the COVID-19 pandemic. Providers must provide additional support and incorporate education about type 1 diabetes management strategies to families affected by large-scale health crises.

Sleep Disturbances in Health Professional Students During the COVID-19 Pandemic: A Concept Analysis

AIM

The aim is to delineate the concept of sleep disturbances in health professional students during the COVID-19 pandemic.

DESIGN

A concept analysis was conducted.

METHODS

A systematic search was conducted for relevant articles published and performed from inception to July 5, 2024. Electronic databases searched included PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Web of Science. Rodgers' method of evolutionary concept analysis was used.

RESULTS

A total of 50 pertinent articles were included in our analysis. Utilising inductive thematic analysis, this study identified attributes, antecedents and consequences of sleep disturbances. Important attributes included insomnia, disrupted sleep patterns, altered sleep duration/nocturnal sleep duration and poor sleep quality. Antecedents encompassed factors such as gender, age/grade levels, physical activity, screen time of digital production, mental health issues, COVID-19-related stressors, financial strain and academic stress. Consequences included both mental and physical health implications. By addressing sleep disturbances and promoting better sleep health among students, we can enhance their learning and performance, which could translate to improved patient care outcomes. Additionally, understanding and mitigating sleep disturbances can contribute to the development of a more resilient and effective health care workforce, capable of providing high-quality care even during crises like the COVID-19 pandemic.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

TRIAL REGISTRATION

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

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/23117.

COVID-19 lockdown and lifestyles: A narrative review

Background

The primary objective worldwide during the coronavirus disease 2019 (COVID-19) pandemic had been controlling disease transmission. However, lockdown measures used to mitigate transmission affected human behavior and altered lifestyles, with a likely impact on chronic non-communicable diseases. More than a year into the pandemic, substantial peer-reviewed literature emerged on altered lifestyles following the varying lockdown measures imposed globally to control the virus spread. We explored the impact of lockdown measures on six lifestyle factors, namely diet, physical activity, sleep, stress, social connectedness, and the use of tobacco, alcohol, or other harmful substances.

Methods

We comprehensively searched PubMed and the World Health Organization's global literature database on COVID-19 and retrieved 649 relevant articles for the narrative review. A critical interpretative synthesis of the articles was performed.

Results

Most of the articles included in the review identified the negative effect of lockdown measures on each of the lifestyle factors in many parts of the world. Encouraging lifestyle trends were also highlighted in a few articles. Such trends can positively influence the outcome of lifestyle-related chronic diseases, such as obesity and diabetes.

Conclusions

The lockdown associated with COVID-19 has largely had a negative impact on the lifestyles of individuals and communities across many countries and cultures. However, some individuals and communities also initiated positive lifestyle-related behavioral changes. If the knowledge generated by studying the impact of COVID-19-related lockdowns on the six lifestyle factors is further consolidated, it could improve chronic disease outcomes. This will help better understand lifestyle behaviors amidst crises and assist in redesigning extreme public health measures such as lockdowns.. It is up to governments, communities, and healthcare/academic entities to derive benefit from lessons learned from the pandemic, with the ultimate objective of better educating and promoting healthy lifestyles among communities.

Predictors of Poor Mental Health Outcomes in Healthcare Workers during COVID-19: A Two Waves Study

Objective: This cross-sectional study aimed to identify potential predictors of poor mental health outcomes among healthcare workers in two different waves of the COVID-19 emergency in Italy. Methods: An online survey collected data from N = 557 healthcare workers (21-77 years). The study predictors were sociodemographic characteristics, occupational status, factors related to the work environment, COVID-19-related adverse events, and lifetime traumatic events. The poor mental health outcomes that were considered were depersonalization/derealization, anxiety, depression, and somatization symptoms. Results: The main predictors of poor mental health outcomes were sleeping less than six hours per night, inadequate protective equipment measures, female gender, personal and familiar infection, living alone, working as a nurse, and working in a COVID-19 ward. Healthcare workers in 2021 reported experiencing more serious accidents and stressful events than those of the first wave. Depressive symptoms and COVID-19-related adverse events were higher in the second pandemic outbreak than in the first. Conclusions: Preventive strategies against poor mental health outcomes should be particularly focused on female nurses who live alone, work in areas with high infection rates, and have experienced the COVID-19 infection personally or who are close to people that have experienced the infection.

Depressive and anxiety symptoms among university students during the later stages of the COVID-19 pandemic in Germany - Results from the COVID 19 German Student Well-being Study (C19 GSWS)

Introduction

Data on the mental health of university students in Germany during the later stages of the pandemic is still limited. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 1.5 years after the first COVID-19 restrictions and (2) which factors were associated with these outcomes.

Methods

The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 6,996 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analyzed using multivariable logistic regression models.

Results

The mean age of the participants was 23.9 years (SD = 4.8), 67% were female and 31% male. The prevalence for depressive symptoms was 29 and 32% for anxiety. The lack of a trusted person and financial difficulties were associated with anxiety and depressive symptoms. Being worried that someone in one's personal network had become severely ill with COVID-19 and concern about (re)infection with COVID-19 were associated with anxiety symptoms. Those with pre-existing health conditions had an up to 1.98-times higher chance for reporting depressive symptoms (OR, 95% CI: 1.01-3.88) and an up to 2.27-times higher chance for anxiety symptoms, respectively (OR, 95% CI: 1.15-4.46).

Conclusion

Concepts for prevention and counseling to tackle mental health problems in students are needed and programs should take specific stressors in times of crises into account.

Flashbulb and first-hand memories for campus closings due to COVID-19: consistency and change

Flashbulb memories (FBM) refer to the vivid and detailed retrieval of the reception context of a highly salient event. We examined FBMs and personal memories for one college's sudden transition to remote learning due to COVID-19. We explored whether the announcement of the campus' closure resulted in FBMs, how respondents felt about the decision, and the impacts of the decision. Employing a two-wave longitudinal survey conducted in March and May 2020, participants responded to questions regarding learning about the campus' closure and a control memory (an event from the same week chosen by participants). Participant reports suggested they did form FBMs, and FBMs were more consistent over time than control memories. Confidence did not differ across memory types. Additionally, we observed an initial strong positive response to the decision to close the campus - a sentiment that intensified over time. Lastly, participants' emotional responses transitioned from negative feelings in the first wave of testing to more neutral feelings in the second. This work offers a unique exploration of FBMs within the broader context of a global health crisis that intruded into daily life, effectively merging the typically public and distant nature of flashbulb events with first-hand, personal experience.

The Relationship between Family Functioning, Emotional Intelligence, Loneliness, Social Support, and Depressive Symptoms among Undergraduate Students

The transition from adolescence to college is a significant developmental stage marked by challenges such as high academic pressure, changes in living environments, and social support systems. These challenges can lead to increased rates of depression among college students. This study investigates the relationships between family functioning, emotional intelligence, loneliness, social support, and depressive symptoms in Chinese college students. A cross-sectional design was employed, with data collected via questionnaires from undergraduate students at Xi'an Jiaotong University. Variables such as family functioning, emotional intelligence, loneliness, social support, and depressive symptoms were assessed. Statistical analyses, including correlation and hierarchical regression, were conducted to explore these relationships. The study found a diverse distribution of depressive symptoms among students, with significant gender differences indicating higher depression rates in females. No significant differences were observed across academic disciplines, grades, or between only children and non-only children. Family functioning, emotional intelligence, and social support were negatively correlated with depressive symptoms, while loneliness was positively correlated. Hierarchical regression analysis confirmed that social support significantly moderated the relationship between family functioning and depressive symptoms. Mediation analysis showed that emotional intelligence and loneliness mediated this relationship. The findings highlight the complex interplay between family dynamics, emotional capabilities, social connectedness, and mental health. Enhancing family functioning, emotional intelligence, and social support can effectively reduce depressive symptoms among college students. These results underscore the need for holistic interventions that address multiple aspects of students' social and emotional lives.

Impact of distress and anxiety due to COVID-19 on digital addictions in university students in the third wave period

Abstract*

Background

Digital addictions are a major problem worldwide, which has increased considerably during the COVID-19 pandemic. In this scenario, two important impact factors to explain this problem are stress and anxiety because of COVID-19. The objective of this research was to determine the impact of distress and anxiety due to COVID-19 on digital addictions.

Methods

cross-sectional, explanatory study. A total of 802 students from public and private universities residing in the city of Lima and Callao (Peru), with a mean age of 21.68 (SD = 3.11), selected by convenience sampling, participated in the study. The MULTICAGE CAD-4 questionnaire, the distress scale, and the COVID-19 worry scale were applied.

Results

two models examined with structural equation modeling showed good fit indices (CFI and TLI > .95, RMSEA and SRMR < .06). The first model shows that the latent variables distress and anxiety due to COVID-19 have direct effects on digital addictions as a general construct (R 2 = 22%). The second model shows that the exogenous latent variables (stress and anxiety) have direct effects of different magnitudes on each digital technology, so the variance explained on smartphone addiction was higher (R 2 = 25%) with respect to internet (R 2 = 19%) and video game addiction (R 2 = 6%). It was also found that for every male, there are two females with high levels of distress and anxiety. Regarding the problematic use of smartphones and internet, there is a prevalence of 40% regardless of sex; but as for the problematic use of video games, there is a marked difference between males (18.8%) and females (2.7%).

Conclusion

the distress and anxiety caused by COVID-19 have a direct impact in aggravating digital addictions.

Utilizing digital technologies to promote well-being in university students: the 'DigiWell' research protocol

The COVID-19 pandemic has significantly impacted the well-being of university students, particularly those in healthcare and medical programs. Psychological interventions rooted in positive psychology have proven effective in enhancing mental health, with online and digital delivery methods proving to be equally viable. This study aims to enhance mental health among Italian university students through digital interventions, including virtual reality, utilizing a stepped care approach. Specific objectives include implementing online positive interventions for students experiencing mild distress (DigiWell_Step 1), evaluating a Virtual-Reality intervention for moderate distress (DigiWell_Step 2), and identifying students experiencing high distress or optimal well-being. Cluster analyses and linear models will assess intervention outcomes. It is anticipated that students undergoing these steps will experience significant improvements in well-being and distress reduction, with sustained benefits at a three-month follow-up. This research contributes to understanding the efficacy of mental health interventions for university students, leveraging digital technologies to enhance accessibility and user engagement. The integration of digital technologies enhances the cost-effectiveness and engagement of interventions delivered through a stepped care approach tailored to the targeted population.

The Effects of Fear of COVID-19 on Future Expectations in Nursing Students in Turkey

This study aims to determine the effects of fear of COVID-19 on future expectations among nursing students. The research is a correlational descriptive study. This study was conducted with 310 nursing students of a state university. The COVID-19 fear and future expectation mean scores of the participants were found, respectively, as 17.16 ± 5.36 and 48.09 ± 8.77. The COVID-19 fear levels of the participants significantly varied based on their gender, whereas their future expectation levels significantly varied based on their place of residence, status of willingly choosing their department and status of having someone in their surroundings and family who had COVID-19 (p < 0.05). No significant relationship was identified between the COVID-19 fear and future expectation levels of the participants (p > 0.05). In this study, it was determined that the COVID-19 fear and future expectation levels of the nursing students were moderate. It was found that fear of COVID-19 did not significantly affect future expectations.

The Impact of COVID-19 Pandemic on Resilience of University Students in the United Arab Emirates: A Cross-Sectional Study

BACKGROUND

The outbreak of the novel Coronavirus pandemic resulted in a sudden change to the daily activities of individuals, including the academic institutions. University-level students are vulnerable to psychological health issues when faced with a large-scale crisis such as the coronavirus disease (COVID-19) pandemic; they need resilience to help them successfully manage and cope with changes.

AIM

The aim of this study was to examine the resilience and associated predictors among university students during the COVID-19 pandemic in the United Arab Emirates.

METHODS

This study employed a cross-sectional descriptive design to examine the levels of resilience and associated predictors of university students. No sampling criterion was set up and all active students from all programs were eligible to participate. A convenience sampling technique was employed for its practical feasibility and efficiency. The data were collected between February 2021 and May 2021.

RESULTS

A total of 2,085 students completed the study questionnaires. The mean score of total resilience among the students was 65.01 (±14.697), while the mean score for personal resilience and caregiver resilience was 38.08 (±8.675) and 26.92 (±6.694), respectively. Comparing total resilience, personal resilience, and caregiver resilience with students' Cumulative Grade Point Average level revealed a significant difference. The predictors of resilience include academic level and number of courses the students enrolled in.

CONCLUSION

Academic institutions need to support the establishment of resilience training programs to prepare students for any challenging time, such as the COVID-19 pandemic.

The influence of attachment style on support and feedback seeking and depression severity among mothers during the COVID-19 pandemic

OBJECTIVES

The ways that people seek support during times of stress influence their mental health outcomes, including depression. Insecure attachment is a risk factor for depression and may also interfere with adaptive support and feedback-seeking behaviour during stress. The purpose of the present study was to test theorized associations between insecure attachment, support and feedback seeking, and changes in depression symptoms over 1 year, in a sample of mothers of school-age children in the context of stress elicited by the COVID-19 pandemic.

METHODS

Participants (N = 70 mothers) completed self-report measures of anxious and avoidant attachment and depression severity at baseline in spring 2020 and then completed measures of past-year engagement in direct and indirect support seeking and excessive reassurance seeking (ERS), preference for negative feedback, and depression severity at a follow-up assessment in summer 2021.

RESULTS

Greater attachment anxiety at baseline predicted more frequent direct support seeking, indirect support seeking, and ERS during the 1-year follow-up period. In turn, greater indirect support seeking predicted greater increases in depression from baseline to follow-up. Greater attachment avoidance at baseline predicted less direct support seeking during the 1-year follow-up period. Greater attachment avoidance at baseline also predicted depression severity at follow-up, particularly among mothers with moderate to high levels of attachment anxiety, although none of the examined support and feedback-seeking behaviours mediated this association.

CONCLUSIONS

These results provide support for the role of activated attachment systems in determining support and feedback-seeking behaviour during stress, as well as the role of support and feedback-seeking behaviour in the maintenance and exacerbation of depression.

A Latent Class Analysis on Indicators of Early Prolonged Grief Disorder and Well-Being Among Dutch Adults Bereaved During the First Year of the COVID-19 Pandemic

Most studies examining prolonged grief disorder (PGD) in people bereaved during the COVID-19 pandemic are focused on psychopathology. However, mental health encompasses both absence of psychopathology and presence of well-being. This is the first study examining symptom profiles of early PGD and subjective mental well-being in 266 Dutch adults recently bereaved during the pandemic. Early PGD and well-being indicators were assessed with the Traumatic Grief Inventory-Self Report Plus and the World Health Organization-Five Well-Being Index, respectively. Latent class analysis identified four classes: low PGD/high well-being (32%), low PGD/moderate well-being (24%), moderate PGD/high well-being (23%) and high PGD/low well-being class (21%). People in the poorer mental health classes were more likely to be female, lower educated, suffering from a mental disorder, have a poor health status, closer kinship to the deceased, and higher risk of severe COVID-19. Classifying adults according to symptom profiles of negative and positive outcomes provides a more complete picture of mental health in bereaved people and offers potential intervention targets.

Does Parasympathetic Nervous System Activity Exacerbate Depressive Symptoms in College Students Who Experienced Parent-Child Separation? A Longitudinal Examination

Childhood separation caused by parental migration increases the risk of suffering depressive symptoms among college students. However, most studies in this field have focused on environmental factors and largely ignored the role of physiological reactivity to stress (e.g., parasympathetic nervous system activity) in this process. The present study examined the long-term effects of the parent-child separation experience on depressive symptoms in college students, and explored the moderating role of parasympathetic nervous system (PNS) activity in these relationships. The participants were 242 college students (Mage = 18.74 years, SD = 0.79; 32.2% male), including 149 college students who experienced parent-child separation and 93 college students without this experience. Using a three-wave longitudinal design, participants completed the measures of the parent-child separation experience, PNS activity (measured via respiratory sinus arrhythmia, RSA), and depressive symptoms at Time 1 (T1, before the COVID-19 lockdown). Their depressive symptoms were again measured at Time 2 (T2, during the COVID-19 lockdown) and Time 3 (T3, after the COVID-19 lockdown). The results showed that the parent-child separation experience positively predicted depressive symptoms in college students at three time points. Moreover, the parent-child separation experience positively predicted depressive symptoms at T2 among males with less and average RSA suppression but positively predicted depressive symptoms at T2 among females with greater RSA suppression. These findings indicate a long-term effect of parent-child separation on depressive symptoms in college students that still exist after they entered university, and that the effect varies depending on PNS activity and gender.

Frontiers and hotspots in anxiety disorders: A bibliometric analysis from 2004 to 2024

Objective

This study aimed to analyze research on anxiety disorders using VOSviewer and CiteSpace to identify research hotspots and future directions.

Methods

We conduct ed a comprehensive search on the Web of Science Core Collection (WoSCC) for relevant studies about anxiety disorders published within the past two decades (from 2004 to 2024). VOSviewer and CiteSpace were mainly used to analyze the authors, institutions, countries, publishing journals, reference co-citation patterns, keyword co-occurrence, keyword clustering, and other aspects to construct a knowledge atlas.

Results

A total of 22,267 publications related to anxiety disorders were retrieved. The number of publications about anxiety disorders has generally increased over time, with some fluctuations. The United States emerged as the most productive country, with Harvard University identified as the most prolific institution and Brenda W. J. H. Penninx as the most prolific author in the field.

Conclusion

This research identified the most influential publications, authors, journals, institutions, and countries in the field of anxiety research. Future research directions are involved advanced treatments based on pharmacotherapy, psychotherapy and digital interventions, mechanism exploration to anxiety disorders based on neurobiological and genetic basis, influence of social and environmental factors on the onset of anxiety disorders.

The relationship between social media dependency and psychological distress due to misunderstanding and fear of COVID-19 in medical students

Improper use of social media during the COVID-19 outbreak, leading to fear and misunderstanding, can contribute to psychological disorders in vulnerable populations. This descriptive and analytical cross-sectional study was conducted in 2023 on 511 medical students of Babol University of Medical Sciences. Data were collected using demographic, psychological distress, fear and misunderstanding questionnaires related to COVID-19 and social media dependency. A total of 511 medical students, with an average age of Mean and S.D; 23.57 ± 3.03 participated in the study. The average psychological distress score was 23.82 ± 7.73 (out of 54), the average score of social media dependency was 17.53 ± 3.09 (out of 30), for the fear of COVID-19 was12.63 ± 2.56 (out of 35), and for the misperception of COVID-19 was 0.53 ± 0.09 (out of 18). Path analysis results) showed that direct path from improper use of social media to psychological distress is significant (P < 0.001, B = 0.19) but this relationship is not significant through fear and misperception related to COVID-19. Improper use of social media, identified as the strongest predictor, can directly increase psychological distress in medical students, without mediation through fear and misperception related to COVID-19. These findings should be taken into consideration when designing and evaluating interventions aimed at promoting mental health and fostering appropriate use of social media among students during disease outbreaks.

Non-suicidal self-injury among youth students during COVID-19 pandemic: the role of psychological factors in Jingzhou, China

Objective

This study aimed to explore the impact of the COVID-19 pandemic on non-suicidal self-injury (NSSI) among youth students, and the mediating role of psychological factors in the relationship between the COVID-19 pandemic and NSSI.

Method

An online survey was conducted at junior and senior high schools, as well as universities located in Jingzhou, Hubei Province, China between June 2021 and January 2022. The COVID-19 Impact Index was constructed using multiple correspondence analysis (MCA) method. The bootstrapping method was used for mediation analysis.

Results

A total of 16025 youth participated in the study and 12507 youth (78.1%) finished the questionnaires. The COVID-19 Impact Index had a significantly positive effect on NSSI (r=0.16, p<0.001). The mediation analysis results showed that the COVID-19 Impact Index had a significant indirect effect on youth' NSSI (β=0.0918, 95% CI [0.0788, 0.1048]), and this indirect effect was mainly achieved through affecting youth' anxiety, depression and post-traumatic stress disorder (PTSD). The mediation effect of anxiety on NSSI was 0.0584, the direct effect was 0.0334, and the mediation proportion was 63.6%. The mediation effect of depression on NSSI was 0.0668, the direct effect was 0.0250, and the mediation proportion was 72.8%. The mediation effect of PTSD on NSSI was 0.0640, the direct effect was 0.0278, and the mediation proportion was 69.7%. All the mediation effects, direct effects and total effects were statistically significant (p<0.001).

Conclusion

The higher the impact of the COVID-19 Impact Index, the higher the prevalence of NSSI among youth students. Anxiety, depression and PTSD had mediated the relationship between the COVID-19 Impact Index and NSSI. It is suggested that specific health policies, mental health services and interventions should be developed to reduce the NSSI and improve mental health status among youth students during the COVID-19 pandemic.

Impact of campus closure during COVID-19 on lifestyle, educational performance, and anxiety levels of college students in China

BACKGROUND

Higher education students exhibit heightened sensitivity to environmental changes as they navigate the critical transition from adolescence to adulthood. The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to universities worldwide, exemplifying a crisis that profoundly affects the learning outcomes and psychological status of college students. Although it is known that campus lockdown has triggered dramatic changes in lifestyles, learning outcomes, and psychological statuses, in-depth knowledge of the causal relationships among these changes remains largely unclear.

METHODS

Here, we conducted a cross-sectional survey designed to assess the impact of campus closure during COVID-19 on lifestyle, educational performance, and anxiety levels among college students. We surveyed over 3,500 junior college, undergraduate and graduate participants from 94 colleges/universities across 30 provinces, municipalities, and autonomous regions in China.We employed structural equation modeling (SEM) to explore the relationships between changes in lifestyle, educational performance, and levels of anxiety associated with campus open or closure regulations during the COVID-19 pandemic.

RESULTS

Our results discovered that sleep duration, physical activity involvement, and social connections were crucial for sustaining students' learning outcomes and mental health. The shift to online learning and campus lockdown exacerbated stressors, contributing to heightened anxiety (β = 0.066), disrupted sleep patterns, and enhanced physical activity (β = 0.070) and reduced learning effect (β = -0.059). Sleep patterns were disrupted by the campus lockdown, an effect mediated by the degradation of relationships among classmates. Nonetheless, the best-fitting SEM uncovered the intricate relationships among lifestyle changes, learning outcomes, and psychological status in response to sudden environmental changes (Fisher's C = 80.949, P = 0.328). These results highlight the critical role of adaptable, supportive campus policies tailored to meet the diverse needs and interests of students during and beyond crises (Fisher's C = 59.568, P = 0.809).

CONCLUSIONS

Our study advocates for a holistic approach that addresses the multifaceted aspects of student life to cultivate a resilient academic community. This approach contributes to a deeper understanding of the effects of sudden environmental changes on students' psychological well-being and academic performance in the post-pandemic era.

Psychological wellbeing of Italian students and clinical assessment tools at university counseling services during the COVID-19 pandemic: a systematic review

Introduction

The COVID-19 pandemic brought about unprecedented problems for contemporary society. Among the numerous challenges faced following the spread of the virus, the need to provide assessment tools and remote psychological assistance certainly deserves particular attention. Indeed, this profound paradigm shift in psychological assessment and care occurred during a period of fragility for people already suffering from the restrictions imposed to stem the spread of the virus. One population particularly affected by the pandemic was students, including university students. The latter faced the pandemic in a particularly critical formative period.

Methods

For these reasons, our systematic review has two main objectives: (i) identify the assessment tools and psychological dimensions most used/investigated during the pandemic in Italian university students; (ii) systematize and deepen our knowledge about the impact of the pandemic on the psychological wellbeing of Italian university students. Our search used PRISMA 2020 guidelines on Web of Science, Pubmed, Scopus, and EBSCOHost.

Results

The results indicated that the psychological dimensions most investigated in university students during the pandemic were anxiety and depression. At the same time, the most used assessment instruments were the State-Trait Anxiety Inventory (STAI-Y) and the Beck Depression Inventory-II (BDI-II). Furthermore, it is clear from the results that the pandemic has harmed the psychological wellbeing of university students. Finally, we dedicated a section to discuss the interventions implemented by university counseling services during the pandemic.

Discussion

This review could improve the work of university counseling services in this post-pandemic period and contribute to developing specific screening and assessment programs for future emergencies.

Anxiety in Nursing Students during the COVID-19 Pandemic: Systematic Review and Meta-Analysis

OBJECTIVES

To analyse the influence of the COVID-19 pandemic on the development of anxiety in nursing students and the factors involved.

DESIGN

A systematic review and meta-analysis.

DATA SOURCE

PubMed, CINAHL, Scopus and Web of Science.

BACKGROUND

Nursing students are at an increased risk of developing mental overload, due to the presence of many sources of stress during their academic training. Therefore, the COVID-19 pandemic has had an impact on the mental health of the general population, especially on healthcare workers and consequently on students undertaking placements in healthcare settings.

METHODS

A systematic review was conducted using PubMed, CINAHL, Scopus and Web of Science databases. A total of 24 articles were included in the review, and 20 articles were selected for the meta-analysis.

RESULTS

We found that the anxiety scores of nursing students during the COVID-19 pandemic were slightly higher (50%) than before the pandemic. The most influential risk factors for developing anxiety were academics, age, gender, having children, living in urban areas or with family, having an addiction to social networks, and having a fear of becoming infected with COVID-19. Resilience, spiritual support and feelings of happiness protected students against the risk of developing high levels of anxiety.

CONCLUSIONS

The COVID-19 pandemic has led to increased levels of anxiety in nursing students. Thirty-five percent of the meta-analytically analysed sample had elevated levels of anxiety.

Disparities and protective factors in pandemic-related mental health outcomes: a Louisiana-based study

Introduction

The COVID-19 pandemic has had a wide-ranging impact on mental health. Diverse populations experienced the pandemic differently, highlighting pre-existing inequalities and creating new challenges in recovery. Understanding the effects across diverse populations and identifying protective factors is crucial for guiding future pandemic preparedness. The objectives of this study were to (1) describe the specific COVID-19-related impacts associated with general well-being, (2) identify protective factors associated with better mental health outcomes, and (3) assess racial disparities in pandemic impact and protective factors.

Methods

A cross-sectional survey of Louisiana residents was conducted in summer 2020, yielding a sample of 986 Black and White adults. The exposure was overall pandemic impact, measured using the Epidemic-Pandemic Impacts Inventory, and the outcome was general well-being (GWB), measured with the General Well-Being Schedule. Potential protective factors included social support, resilience, and social cohesion. Linear regression models were constructed to examine the association between pandemic impact and GWB, with each protective factor added as an effect modifier. These relationships were further assessed for differences by race.

Results

Pandemic stressors can be grouped into social, health, work, finance, and family-related impacts. Black persons displayed higher levels of pandemic impact as well as lower levels of social support, resilience, and social cohesion (p < 0.0001), highlighting existing racial disparities, though Black respondents and White respondents exhibited no differences in general-well being. Social support, resilience, and social cohesion were identified as protective factors for both groups (p < 0.0001, respectively), but these protective effects deteriorated as pandemic impacts increased. The addition of a pandemic impact by race interaction term was also significant in each model (p = 0.0020, p < 0.0001, and p = 0.0095, respectively) and showed that the protective effects of social support and resilience deteriorated more rapidly for Black persons than White persons, while the protective effects of social cohesion deteriorated more rapidly for White persons than Black persons.

Discussion

This study emphasizes the importance of psychosocial resources in buffering the mental health impact of pandemics. It also suggests greater vulnerability for marginalized communities lacking access to crucial support systems. Findings underscore the need for targeted interventions that bolster access to social support, promote resilience, and strengthen social cohesion, particularly within minority groups. Additionally, policymakers should consider proactive measures to assist in recovery and mitigate the disproportionate impact of future crises on vulnerable populations.

Symptoms of Post-Traumatic Stress and Mental Health in a Sample of University Students: The Mediating Role of Resilience and Psychological Well-Being

The COVID-19 pandemic has been one of the most stressful events in recent times across the world. The long-term effect of these experiences raises several concerns, including the development of post-traumatic stress symptomatology. However, little is known about the psychological processes that mediate this association. The aim of this study was to explore the association of emotional exhaustion and anxiety in post-traumatic stress symptomatology, and the mediating role of resilience and psychological well-being in university students. A total of 526 university students of both sexes participated in this study, and they were aged between 17 and 62 years old. Symptoms of anxiety and emotional exhaustion were significantly higher in females, in contrast, males showed on average more resilience and psychological well-being. Additionally, participants with COVID-19 infection had higher levels of emotional exhaustion, anxiety, and PTSD. The results indicated that the variables were correlated with each other (p < 0.001). A conceptual model was confirmed that describes anxiety and emotional exhaustion as predictors, post-traumatic stress symptomatology as an outcome variable, and resilience and psychological well-being as mediators. Resilience and psychological well-being can be important protective factors for adaptive responses in stressful situations. The findings obtained in this study will provide a theoretical basis for designing targeted interventions to improve psychological health, whether for crisis intervention, the process of adapting to higher education, or for recovery plans from psychological trauma.

Screen viewing patterns and their association with mental wellbeing and psychological distress: a cross-sectional study amongst university students

BACKGROUND

Dependency on screen viewing (SV) has reached unprecedented levels, and mental health issues are becoming a major public health concern. However, the associations between SV, including variations in purposes, devices, and timing, and mental health remain unclear. This study aims to provide insights into these associations among university students.

METHODS

This analysis used baseline data from a longitudinal cohort study among first-year university students matriculating in the 2021-2022 academic year. Self-reported data on sociodemographics, health behaviors and mental health outcomes alongside anthropometric measurements were collected. Unadjusted and adjusted logistic regression analyses were conducted.

RESULTS

The average age of the 997 valid students was 20.2 years, with 59.6% being female and 41.4% male. Students spent 14.3 h daily on SV, with females reporting higher SV than males. Daily SV was predominant for study purposes (7.6 h/day). Computer usage was the highest (7.0 h/day), while TV usage was the lowest (1.7 h/day). Poor mental wellbeing was reported by 33.6% of students, while 13.9% experienced psychological distress. Compared to students with low total SV, those with high levels were more likely to have poor mental wellbeing [OR (95% CI): 1.40 (0.99, 1.98)] and psychological distress [1.56 (1.00, 2.44)]. High levels of recreational and study related SV were significantly associated with poor mental wellbeing [1.81 (1.27, 2.56)] and psychological distress [1.75 (1.11, 2.83)], respectively. Those with high levels of computer time were more likely to have poor mental wellbeing [1.44 (1.01, 2.06)], and high weekend day SV was associated with greater odds of psychological distress [2.16 (1.17, 4.06)].

CONCLUSIONS

SV among university students was high, as was the high prevalence of poor mental wellbeing and psychological distress. Greater SV was associated with poor mental wellbeing and psychological distress. Differences according to purpose of SV were noted. Although recreational SV was associated with poor mental wellbeing, study related SV was associated with psychological distress. Variations across different devices and timing were also noted. This highlights the need for further longitudinal research to understand the impact of SV on mental health and to guide interventions for promoting mental health of university students globally.

Exercise, mental well-being and burnout in Thai medical students in 2020-2021: an online cross-sectional survey

INTRODUCTION

Within the Thai medical curriculum, its rigorous education framework, demanding schedules and high academic standards can contribute to psychological distress. Regular physical activity has consistently shown positive effects on mental health. The aim of the study was to investigate the association between exercise and psychological well-being, including depression, anxiety, and burnout, in Thai medical students, and factors related to insufficient exercise and depression.

METHODS

The cross-sectional study was conducted among medical students in the university hospital during 2020-2021. Participants completed self-administered questionnaires consisting of demographic data, Godin-Shephard Leisure-Time Physical Activity Questionnaire, depression screening (9Q), Thai General Health Question-28 (4 domains: somatic symptoms, anxiety and insomnia, social dysfunction, severe depression), and Maslach burnout inventory (Emotional exhaustion (EE), Depersonalization (DP), Reduced Personal Achievement (rPA).

RESULTS

Of the 404 participants, 50.5% were women, the mean age (SD) was 21.06 (1.8) years, and 52% were in clinical years. The prevalence of insufficient exercise was 59.6%, depression (30.2%), somatic symptoms (27.7%), anxiety (30.7%), insomnia (89.4%), social dysfunction (89.4%), high level of EE (32.4%), DP (21%), and rPA (56.7%). Insufficient exercise was associated with moderate to severe depression (OR 2.89, 95% CI 1.16-7.25), anxiety and insomnia (OR 1.56, 95% CI 1.01-2.43), social dysfunction (OR 2.51, 95% CI 1.31-4.78), burnout in part due to high rPA (OR 2.4, 95% CI 1.4-4.13), and study in clinical years (OR 1.91, 95% CI 1.28-2.87). After adjusted significant factors, only studying in the clinical year, social dysfunction, and burnout in part of rPA were related to insufficient exercise.

CONCLUSIONS

High rates of insufficient exercise, psychological challenges, and burnout were prevalent among medical students. To effectively address these issues, medical school should advise students to participate in regular exercise, promoting mental well-being and healthier lifestyles.

Validity Evidence of a Screening Tool for Early Detection of Clinical Crisis-Related Anxiety Amongst Medical Students

Construct: Psychological distress among students is a growing concern in medical education, even more so with the advent of COVID-19 pandemic. Anxiety is among students' mental health issues. High and persistent anxiety has many negative impacts on students' academic and personal life. Early detection is essential for timely intervention. Background: Currently, medical student anxiety is assessed using tools primarily designed for psychiatric purposes. Despite their excellent validity evidence, these tools contain sensitive items and do not explore stressors related to clinical activities. There is a need for contextualized tools to better identify anxiety-provoking factors specific to the medical education environment. Approach: We previously developed the Crisis Experience Rating Scale (CERS-7), a short screening tool to identify early on anxious students participating in clinical activities during the first wave of the COVID-19 pandemic. The present study sought to produce further validity evidence for the CERS-7. Medical students in their clinical years at two Swiss and one French medical school, all involved in COVID-19 clinical activity during the second wave of the pandemic, completed the CERS-7 and the State Anxiety Inventory (STAI-A), the best known and widely used tool to measure for general anxiety. We evaluated internal structure using confirmatory factor analysis (CFA) and relation to other variables using linear regression (LR) and receiver operating characteristic (ROC) curves with thresholds defined using the Youden index. Findings: There were 372 participants. CFA confirmed the two-factor structure of the CERS-7 scale from first-wave dataset. The CERS-7 total scale and subscales demonstrated validity evidence in relationship to the STAI-A scores and categories. A CERS-7 total scale score < 27.5 identified 93% of severely anxious students. Conclusion: The CERS-7 produces reliable scores to use for monitoring anxiety status when assigning students to clinical settings as well as for improving training conditions during clinical crisis.