University students' mental health amidst the COVID-19 quarantine in Greece

Coronavirus-Related Stressors, Resilient Mindset, Loneliness, Depressive Symptoms in College Students: Testing a Moderated Mediation Model

The coronavirus (COVID-19) outbreak alarmingly threats the mental health and functioning of people globally. The present study aims to examine the moderated mediation role of resilient mindset and loneliness in the association of coronavirus stress and depressive symptoms. We recruited 394 undergraduate students from a state university in Türkiye, ranging in age between 18 and 47 years (M = 22.76, SD = 3.88; 65% female). The main results revealed that resilient mindset mediated the relationship between coronavirus-related stress and depressive symptoms. Moreover, loneliness moderated the mediating effect of resilient mindset in the coronavirus stress and depressive symptoms association. Taken together, these findings pointed out that the effects of the coronavirus stress on depressive symptoms can be captured better by underlying psychological mechanisms, namely resilient mindset and loneliness.

SCIP: a self-paced, community-based summer coding program creates community and increases coding confidence, lessons learned from the pandemic

In 2020, many students lost summer opportunities due to the COVID-19 pandemic. We wanted to offer students an opportunity to learn computational skills and be part of a community while they were stuck at home. Because the pandemic was very isolating, it was important to support students to learn and build community online. We used lessons learned from literature and our own experience to design, run and test an online program for students called the Science Coding Immersion Program (SCIP). In our program, students worked in small teams for 8 hours a week spread over the week, with one participant as the team leader and Zoom host. Teams worked on an online R or Python class at their own pace with support on Slack from the organizing team. For motivation and career advice, we hosted a weekly webinar with guest speakers. We used pre- and post-program surveys to determine how different aspects of the program impacted students. We were able to recruit a large and diverse group of participants who were happy with the program, found community in their team, and improved their coding confidence. We hope that our work will inspire others to start their own version of SCIP.

A Prospective, Longitudinal Comparison of Sexual Distress Across Relationship Status During the COVID-19 Pandemic

Numerous studies have described declines in sexual well-being during the COVID-19 pandemic, although experiences of sexual distress during this time appear to be mixed. Previous research has relied on cross-sectional methodology and focused on individuals in relationships. Furthermore, little is known about the frequency of "COVID-safe" sexual behaviors, such as online sexual activities. These gaps in the literature were addressed using a prospective, longitudinal online study examining sexual distress, predictors of sexual distress (i.e., perceived stress), and online sexual activities over time in single and partnered individuals. Participants were single (N = 64) and partnered (N = 60) individuals who completed surveys at three timepoints over a 6-month period during the COVID-19 pandemic. Mean age across the two groups was 29 years, and approximately half were women (51.6% and 50%, respectively). Results indicated that single individuals reported significantly higher sexual distress than partnered individuals at Times 1 and 2, but not at Time 3. Sexual distress significantly decreased over time for individuals in the single group but remained stable for partnered individuals. At each timepoint, there was a conditional effect of perceived stress on sexual distress depending on one's relationship status, and the nature of these conditional effects changed throughout the course of the study. Results suggested that single individuals demonstrated improvements in sexual distress over time. Perceived stress is an important predictor of sexual distress but may operate differently depending on relationship status. Results highlight the resiliency of both single and partnered individuals during the COVID-19 pandemic.

Exploring the Psychological Impact of Quarantine: An Investigation into Eating Patterns, Emotions, and Loneliness During the COVID-19 Pandemic in Greece

PURPOSE

The implementation of quarantine measures in response to the COVID-19 pandemic presented challenges linked to adverse psychological effects, notably affecting individuals' eating patterns. This study aimed to investigate the eating patterns of individuals during lockdowns compared across sex, age, and income levels, and examine the influence of positive and negative emotions, as well as loneliness, on these patterns.

METHODS

A cross-sectional online study was conducted with 450 participants (aged 18-74 years old). One questionnaire about demographics, the Demographic Questionnaire, and three validated self-report scales (Eating Attitudes Test, comprising the Dieting, Bulimia, and Food Preoccupation, and Oral Control subscales, the Modified Differential Emotions Scale, and the UCLA Loneliness Scale) were employed. Convenience and snowball sampling were used. The data were collected between April and May 2021, primarily through social media platforms, such as Facebook, Instagram, and Twitter. The survey questionnaire was shared via these platforms and users could answer if they wanted. Also, they were asked to send the questionnaire to their close contacts. Additionally, the survey questionnaire was distributed face-to-face to 80 participants. The statistical analyses included linear regression and mediation analyses.

RESULTS

 Abnormal eating patterns (e.g. eating behaviors that tend to have signs of diet such as constant avoidance of fattening foods, the individual's involvement with becoming leaner, extreme control or preoccupation with food, overeating and purging methods) were identified in 25% of the 450 participants participated in this survey, aged 18-74 years. Moderate levels of negative/positive emotions and loneliness were predominantly reported. Female sex was significantly associated with abnormal eating patterns (p=0.010), particularly dietary behaviors (p=0.029). Negative emotions (p=0.032) and loneliness (p=0.001) emerged as predictive factors for overall eating patterns and bulimic behaviors. Negative emotions exhibited a direct correlation with eating patterns, while loneliness played a significant mediating role (p=0.032). Furthermore, the association between negative emotions and bulimia was partially mediated by loneliness (p=0.018).

CONCLUSIONS

This study underscores the pivotal roles of negative emotions and loneliness in shaping eating patterns during quarantine. Multilevel public health interventions are needed to address the negative effects of quarantine and pandemics in general. Screening tests for mental health in the school and job environments could highlight the need for shaping interventions, such as counseling, group empowerment, and family support in order to mitigate the negative impact of the COVID-19 pandemic on eating behaviors and mental health in general.

Stigma towards mental illness, resilience, and help-seeking behaviours in undergraduate students in Hong Kong

AIM

Early interventions have great impact on reducing burden of mental illness. Young people are however the least likely to seek help for psychological issues. Resilience and stigma towards mental illness have been identified as contributing factors, although previous findings were mixed with potentially complex interaction with symptom severity. We investigated the relationship between stigma, resilience, depressive symptom severity, and help-seeking behaviours in undergraduate students in Hong Kong.

METHODS

A cross-sectional online survey was conducted among undergraduates from a university in Hong Kong (n = 945). The 21-item Stigma and Acceptance Scale, Connor-Davidson Resilience Scale, and the Patient Health Questionnaire-9 were used. History of help-seeking for psychological issues was self-reported. Path analysis was conducted to test a conceptual model of their relationships.

RESULTS

Among those with moderate-to-severe depressive symptoms (39.5%), only one-fourth had sought professional help. The path model showed that depressive symptom severity and stigma were positively associated with help-seeking behaviours, while resilience was negatively associated with help-seeking behaviours independently (all p < .001). Subgroup analyses showed differential contribution of stigma and resilience to a history of help-seeking in those with minimal-to-mild symptoms compared with moderate-to-severe symptoms.

CONCLUSIONS

Stigma may be a barrier for help-seeking particularly in students with moderate-to-severe depression. Higher levels of resilience in young people may be protective and reduce the unnecessary seeking of professional help. Therefore, enhancing resilience among students in general, and reducing stigma and promoting help-seeking behaviours for those who have moderate-to-severe symptoms should be consider in parallel as strategies to enhance mental wellbeing of students.

Association of habitual physical activity with depression and anxiety: a multicentre cross-sectional study

OBJECTIVE

Despite the known benefits of physical activity, the effect of habitual physical activity (HPA) on depression and anxiety remains unclear. This study aimed to investigate the association of HPA with the risk of depression and anxiety among Chinese adults, with the consideration of disease severity.

METHODS

The participants in this multicentre cross-sectional study were from the nationwide survey of the psychology and behaviour of Chinese residents. Depression and anxiety were measured using the nine-item Patient Health Questionnaire and seven-item Generalised Anxiety Disorder scale. HPA was assessed by the short form of the International Physical Activity Questionnaire. Crude and adjusted ORs with their 95% CIs were estimated by using ordinal logistic regression.

RESULTS

Of the 19 798 participants, 3901 (19.7%) had anxiety and 8914 (45.02%) had depression. Compared with inactive participants, depression risk in individuals reporting low, median and high volume HPA was reduced by 23% (OR 0.77, 95% CI 0.66 to 0.89), 21% (OR 0.79, 95% CI 0.68 to 0.90) and 13% (OR 0.87, 95% CI 0.78 to 0.98), respectively, after adjustment for confounder. No significant association of HPA with anxiety risk was observed.

CONCLUSION

Participation in HPA, whether low, median or high volume, was associated with a lower risk of depression compared with inactive participation, while no significant association was observed between HPA and anxiety.

Isolating unique variance in mental health outcomes attributable to personality variables and childhood emotional abuse

Introduction

University students are at high risk for anxiety and depression. Our main objective was to tease apart variance in symptom severity that was uniquely attributable to four associated variables that are frequently confounded: exposure to childhood emotional abuse, alexithymia, sensory processing sensitivity (SPS), and anxiety sensitivity (AS).

Methods

University students (N = 410) completed an online survey designed to measure our four key study variables along with several other potentially relevant variables including sex, physical activity levels, and perceived COVID-19 impacts.

Results

Over half of the participants reported moderate to extremely severe symptoms of anxiety and depression. Females reported stronger signs of SPS and AS and were more likely than males to have increased their moderate/vigorous exercise since the pandemic began. After controlling for the other variables, the best predictors of perceived COVID-19 impacts were SPS, childhood emotional abuse, and current levels of physical activity. Whereas all three personality variables and childhood emotional abuse emerged as significant predictors of both depression and anxiety, neither COVID-19 impacts nor physical activity levels accounted for unique variance in either model. Unexpectedly, male sex emerged as an additional risk factor for depression, raising the possibility that males experience unique stressors and societal pressures that increase their risk of depression.

Discussion

These findings help to clarify the links between childhood emotional abuse, personality traits implicated in emotional awareness and self-regulation, and mental health. They may have important implications for the development and implementation of individualized treatments for common mental disorders.

Students' mental health during the pandemic: results of the observational cross-sectional COVID-19 MEntal health inTernational for university Students (COMET-S) study

Introduction

The aim of the study was to search rates of depression and mental health in university students, during the COVID-19 pandemic.

Materials and methods

This is an observational cross-sectional study. A protocol gathering sociodemographic variables as well as depression, anxiety and suicidality and conspiracism was assembled, and data were collected anonymously and online from April 2020 through March 2021. The sample included 12,488 subjects from 11 countries, of whom 9,026 were females (72.2%; aged 21.11 ± 2.53), 3,329 males (26.65%; aged 21.61 ± 2.81) and 133 "non-binary gender" (1.06%; aged 21.02 ± 2.98). The analysis included chi-square tests, correlation analysis, ANCOVA, multiple forward stepwise linear regression analysis and Relative Risk ratios.

Results

Dysphoria was present in 15.66% and probable depression in 25.81% of the total study sample. More than half reported increase in anxiety and depression and 6.34% in suicidality, while lifestyle changes were significant. The model developed explained 18.4% of the development of depression. Believing in conspiracy theories manifested a complex effect. Close to 25% was believing that the vaccines include a chip and almost 40% suggested that facemask wearing could be a method of socio-political control. Conspiracism was related to current depression but not to history of mental disorders.

Discussion

The current study reports that students are at high risk for depression during the COVID-19 pandemic and identified specific risk factors. It also suggested a role of believing in conspiracy theories. Further research is important, as it is targeted intervention in students' groups that are vulnerable both concerning mental health and conspiracism.

Predictors of suicidality among Polish university students during COVID-19 pandemic

PURPOSE OF REVIEW

The main purpose of the study was to assess university students' mental health and identify factors associated with the risk of suicidal thoughts, plans, and attempts during coronavirus disease 2019 (COVID-19) pandemic and distance learning.

RECENT FINDINGS

The study was conducted in spring 2021 and comprised 10 760 Polish students. The survey employed modified versions of the C-SSRS, CIDI, WHO-5, GAD-7, the PTSD checklist for DSM-5 and CAGE-AID Questionnaire and included questions about panic attacks, COVID-19-related information and sociodemographic characteristics. The correlates of suicidality were examined using a series of logistic regression analyses. Almost 40% students experienced any suicidal thoughts and/or behaviours in the previous month: passive ideations only (15.8%), active ideations only (7.1%), plans without attempts (15%), and attempts (1.4%). Following variables were related to the increased risk for suicide attempts: severe anxiety [odds ratio (OR) = 11.39; 95% confidence interval (CI): 1.44-90.26], panic attacks (OR = 3.21; 95% CI: 1.75-5.91), and COVID-19 hospitalisation (OR = 11.04; 95% CI: 1.17-104.59). Major depression was associated with passive and active ideations, suicide plans, but not with attempts (OR = 1.37; 95% CI: 0.45-4.13).

SUMMARY

University students present a high level of adverse mental health and increased risk of STBs during COVID-19 pandemic. A suicide prevention program tailored to this population is needed during and after the pandemic.

Virtual Schooling and Pediatric Mental Health During the COVID-19 Pandemic

In this single-site, retrospective, descriptive chart review and survey, we investigated changes in pediatric behavioral health needs during the COVID-19 pandemic and the relationship between virtual schooling and hospitalized children's mental health. Subjects included patients aged 6 and 18 years during the 2015 to 2019 and 2020 to 2021 school years who received inpatient mental health care. Parents of patients admitted in 2020 to 2021 were surveyed regarding their child's schooling. We additionally described and compared subjects using descriptive data, including proxies for illness severity, and assessed how these outcomes changed during the pandemic and correlated with school modality. During the pandemic, the distribution of diagnoses changed, and some markers of severity increased. Patients in exclusively virtual school had higher rates of mood and anxiety disorders and tic disorders, and lower rates of eating and disruptive behavior disorders, than patients with recent in-person school. Further study is needed regarding the impact of virtual schooling on pediatric mental health.

Mental health of junior college students in China during COVID-19 school lockdown: Findings of on-line cross-sectional survey

During the COVID-19 pandemic, junior students who had recently entered university may have experienced particular difficulties. This study aimed to investigate the incidence of anxiety, depression, and sleep status among junior college students during school closure. Junior college students from 3colleges in Anhui Province participated in this study from 6th to 20th April, 2022. The students' data were collected using a designed online questionnaire developed on the "Wen juan xing" website and submitted via cell phone. Ordinal logistic regression analysis indicated that female sex was an independent risk factor for increased anxiety, depression, and insomnia (anxiety: OR 1.503, 95% CI 1.191-1.897; depression: OR 1.14, 95% CI 1.023-1.270; ISI OR 2.052, 95% CI 1.646-2.559). Notably, medical specialty was an independent risk factor for depression and anxiety (anxiety: OR 1.367, 95% CI 1.078-1.734; depression: OR 1.289, 95% CI 1.148-1.448). Moreover, being a freshman was a risk factor for increased depression and insomnia (depression: OR 1.036,95% CI 0.931-1.153; insomnia: (OR 1.157,95% CI 0.961-1.394). The findings indicate that a considerable portion of junior college students experienced psychological problems due to lockdowns during the COVID-19 pandemic.

Machine learning identifies a COVID-19-specific phenotype in university students using a mental health app

Background

Advances in smartphone technology have allowed people to access mental healthcare via digital apps from wherever and whenever they choose. University students experience a high burden of mental health concerns. Although these apps improve mental health symptoms, user engagement has remained low. Studies have shown that users can be subgrouped based on unique characteristics that just-in-time adaptive interventions (JITAIs) can use to improve engagement. To date, however, no studies have examined the effect of the COVID-19 pandemic on these subgroups.

Objective

Here, we sought to examine user subgroup characteristics across three COVID-19-specific timepoints: during lockdown, immediately following lockdown, and three months after lockdown ended.

Methods

To do this, we used a two-step machine learning approach combining unsupervised and supervised machine learning.

Results

We demonstrate that there are three unique subgroups of university students who access mental health apps. Two of these, with either higher or lower mental well-being, were defined by characteristics that were stable across COVID-19 timepoints. The third, situational well-being, had characteristics that were timepoint-dependent, suggesting that they are highly influenced by traumatic stressors and stressful situations. This subgroup also showed feelings and behaviours consistent with burnout.

Conclusions

Overall, our findings clearly suggest that user subgroups are unique: they have different characteristics and therefore likely have different mental healthcare goals. Our findings also highlight the importance of including questions and additional interventions targeting traumatic stress(ors), reason(s) for use, and burnout in JITAI-style mental health apps to improve engagement.

Relationship between Fear of COVID-19, Intolerance of Uncertainty, and Coping Strategies on University Students' Mental Health

BACKGROUND

the mental health of students was particularly affected by the COVID-19 pandemic. The present study therefore examined the relationships between anxiety and depressive symptoms, eating-related problems, coping, fear of COVID-19, and intolerance of uncertainty.

METHODS

2139 French students of 54 universities were recruited in the different regions of France during a French lockdown (between 21 April and 3 May 2021). Six variables were measured: fear of COVID-19, intolerance of uncertainty, coping, anxiety and depressive symptoms, and eating-related problems. To explore the directions of the relationships between our variables of interest, we calculated a directed acyclic graph.

RESULTS

our data highlighted the central roles of intolerance of uncertainty in students' anxiety and depressive symptoms, and the direct role of prospective intolerance of uncertainty on eating-related problems.

CONCLUSIONS

these findings indicate that intolerance of uncertainty should be targeted by interventions designed to help students with high levels of anxiety, depressive symptoms, and/or eating-related problems.

Caught between relief and unease: How university students' well-being relates to their learning environment during the COVID-19 pandemic in the Netherlands

Previous literature shows that university students are particularly vulnerable to psychological ill-being. Also throughout the COVID-19 pandemic, stressors ranging from uncertainty to disruption of social lives have influenced their well-being. Resilience as a psychological resource could help students deal with such crises. Furthermore, students' learning environment can substantially determine their well-being and resilience, by satisfying their basic psychological needs for autonomy, competence, and relatedness. The present study aims to longitudinally investigate students' well-being and resilience in relation to their learning environment. To this end, we interviewed six participants, of which two were university students, two university teachers, one study advisor, and one student psychologist. With a longitudinal interview study with four dates of measurement, spanning the pre to mid-COVID-19 pandemic period, we gathered commentary about the evolution of student well-being, resilience factors, and the effects of the learning environment. To analyse the interview data, we used thematic inductive and deductive coding. The participants confirmed the postulated stressors, but also positive consequences for student well-being, including resilience growth. Interviewees also reported a variety of resilience factors, both within the individual (e.g. social support) and within academia (e.g., impaired student-teacher relationship, diminished sense of belonging). Furthermore, the interview data indicate changes in teaching related to students' needs for autonomy, competence, and relatedness, which in turn have consequences for learning and engagement, including challenges, opportunities, and positive outcomes. These findings, connecting the learning environment to student well-being and resilience, may help reshape academic systems for the post-pandemic future.

Mental illness through the perspective of undergraduate medical students in Greece: a cross-sectional study at Aristotle University of Thessaloniki

Introduction

Numerous studies reveal that mental health-related stigma, stereotypes, and prejudices negatively affect the patients, jeopardizing their health, prognosis, and social opportunities. Healthcare professionals, who are in the first line of combating mental disease, are expected to play a significant role in drastically changing discriminatory and stigmatizing attitudes toward psychiatric patients and in diminishing the existing healthcare and social disparities. In this study, we aimed to explore and highlight the views of Greek medical students-that is of the future physicians-toward mental illness and people suffering from it.

Materials and methods

It is a cross-sectional, observational study, in which 324 undergraduate students from the most populous Greek medical school of the Aristotle University of Thessaloniki, participated online, during the spring semester of 2022. The tools used were the Opinions about Mental Illness Scale (OMI) that assesses one's viewpoints about mental illness, the Social Distance Scale (SDS) that captures the desired degree of social distancing from patients with mental disorders, and the Level of Contact Report (LCR-12) that estimates the level of familiarity with them.

Results

Participants displayed rather positive attitudes regarding the etiology of mental illness, social integration, and discrimination toward psychiatric patients [as evaluated with the respective OMI subscales; Etiology mean score (μ):8.87 ± 4.68, Social Integration (μ):17.79 ± 5.42, Social Discrimination (μ):13.54 ± 11.17], and more clearly favorable opinions concerning the need for social provision or the enactment of restrictive measures [as expressed with the relative OMI subscales; Social Care (μ):22.74 ± 4.56, Social Restriction (μ):13.27 ± 8.98], while claiming to be quite familiar with mental disorders and individuals experiencing them (as assessed with LCR; μ: 8.71 ± 2.16), and relatively willing to interact with them (as measured with SDS; μ:8.95 ± 4.23). Degree of familiarity with mental illness was directly proportional to the desire for contact with patients living with it, while the higher both were, the more improved most of the aforementioned OMI sectors were found to be. Female sex, clinical medical education, previous clinical psychiatric training, and living with or being a person with a mental disorder were the factors that defined a statistically refined profile in many of the aspects above.

Conclusion

Our findings are in accordance with many prior and recent studies, while showing improved opinions compared to those of previous research in Greek student and healthcare population. They are calling for vigilance, rather than complacency, as well as educational and social interventions, in order to enable current and future healthcare professionals to perform their function to its fullest extent. Implications of our results and further research suggestions are included.

Discovering the Learning Gradient of Students' Preferences for Learning Environment

The aim of this study was to examine the effects of online learning self-regulation on learning outcomes during the COVID-19 pandemic lockdown among university college students. Quantitative k-means cluster analysis was used to examine the relationship among students in three different clusters based on their preferences toward online learning. The results indicated that online learning self-regulation had a significant positive effect on learning outcomes due to the shift to online learning. Thus, we identified a "learning gradient" among students, showing that cluster 1 students (preferences for 100% online) have the most positive preferences toward online teaching and the highest degree of self-regulation and learning outcome, cluster 2 students (moderate preferences for both physical and online teaching) are mixed (both positive and negative experiences) and moderate self-regulation and learning outcomes while cluster 3 students (preferences for physical classroom teaching) have the most negative preferences and the lowest self-regulation and learning outcome. The results from this study show that students' self-regulated learning strategies during online teaching environments are important for their learning outcomes and that cluster 1 and 2 students especially profited from the more flexible online learning environment with organized and deep learning approaches. Cluster 3 students need more support from their educators to foster their self-regulation skills to enhance their learning outcomes in online teaching environments.

The Relationship between Physical Activity and Life Satisfaction among University Students in China: The Mediating Role of Self-Efficacy and Resilience

(1) Background: Universities play a crucial role in nurturing healthy habits, and physical activity has emerged as a valuable tool for enhancing the life satisfaction, self-efficacy, and resilience of college students. Therefore, the purpose of this study was to investigate the mediating role of physical activity in the relationship between life satisfaction and self-efficacy as well as resilience among Chinese university students. (2) Method: This study used the Physical Activity Rating Scale (PARS-3), the Self-Efficacy Scale (CGES), the Mental Toughness Scale (CD-RISC), and the Life Satisfaction Scale (CSLSS) to administer questionnaires to 353 university students from two universities in Chengdu, Sichuan Province. Using a random simple sampling method, the data were processed and analyzed using SPSS 22.0 and Excel software. (3) Results: (1) Physical activity exhibited a significant positive correlation with self-efficacy, resilience, and life satisfaction; self-efficacy was significantly and positively related to resilience and life satisfaction; and resilience was significantly and positively related to life satisfaction. (2) Physical activity had a positive predictive effect on life satisfaction (β = 0.2771; 95% confidence interval (CI): 0.1905, 0.3637, 55.51%). (3) Self-efficacy (β = 0.0368; 95% confidence interval (CI): 0.0087, 0.0692, 7.37%) and resilience (β = 0.137; 95% confidence interval (CI): 0.0919, 0.1894, 27.44%) mediated the relationship between physical activity and life satisfaction. Also, the chain-mediating effect of self-efficacy and resilience between physical activity and life satisfaction reached significant levels (β = 0.0483; 95% confidence interval (CI): 0.0279, 0.0745, 9.68%). (4) Conclusion: Active participation in physical activity not only enhanced the life satisfaction of college students but also indirectly impacted their life satisfaction by improving their self-efficacy and resilience. Consequently, this led to an overall improvement in the life satisfaction of college students.

Acceptability and Feasibility of Online Support Groups for Mental Health Promotion in Brazilian Graduate Students During the COVID-19 Pandemic: Longitudinal Observational Study

BACKGROUND

The outbreak of the COVID-19 pandemic in 2020 aggravated already existing difficulties and added new challenges for students. Owing to the gap between needed and available psychological services, group interventions may offer a helpful strategy for student mental health promotion.

OBJECTIVE

This study aimed to investigate the acceptability and feasibility of a 4-week online support group program designed for mental health promotion tailored to graduate students at a Brazilian public university in the context of the COVID-19 pandemic (May 2022 to June 2022).

METHODS

Participants in the program took part in online support groups based on a pilot group facilitated by a trained clinical psychologist. Self-administered, standardized web-based questionnaires were assessed at the baseline (T0; before the intervention), postintervention (T2), and follow-up (T3; after 4-6 weeks) time points. We measured sociodemographic variables, treatment credibility and expectancy (Credibility and Expectancy Questionnaire), satisfaction (Client Satisfaction Questionnaire), negative effects of the intervention (Negative Effects Questionnaire), depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), and participants' quality of life (abbreviated World Health Organization Quality of Life assessment). A 9-answer option questionnaire and open-ended questions also assessed the group's perceived positive and negative outcomes.

RESULTS

The total sample comprised 32 participants. Most (23/32, 72%) were doctoral students. Credibility and expectancy scores were high. Participants' satisfaction (Client Satisfaction Questionnaire) with the program was high at the postintervention (T2) and follow-up (T3) evaluations (T2: mean 28.66, SD 3.02; T3: mean 27.91, SD 3.02). Most participants reported that they could learn from other participants' experiences (T2: 29/32, 91%; T3: 27/32, 84%) and felt encouraged to take better care of themselves (T2: 22/32, 69%; T3: 24/32, 75%). None of the participants reported that they had no benefits from the program. The PHQ-9 scores showed mild to moderate depressive symptoms (mean 9.59, SD 6.34), whereas the answers of 9% (3/32) of the participants to the PHQ-9 item 9 indicated suicidality at baseline (T0). Finally, the 4 domains of quality of life (physical: P=.01; psychological: P=.004; social: P=.02; and environmental: P<.001) showed a slight and statistically significant improvement at the postintervention evaluation (T0: mean 57.03, SD 15.39 to 59.64, SD 17.21; T2: mean 64.32, SD 11.97 to 68.75, SD 8.87).

CONCLUSIONS

Online support groups for the mental health promotion of graduate students are feasible and can be especially useful for universities with students allocated to different cities. They are also satisfactory and may positively influence participants' quality of life. Therefore, they can be considered a helpful mental health promotion strategy in the educational context. Further studies could evaluate these (or similar) programs under nonpandemic circumstances.

Resilience, Positivity and Social Support as Perceived Stress Predictors among University Students

Since the COVID-19 pandemic, researchers have been trying to identify which personal resources can contribute to minimizing the mental health costs in students incurred due to the restrictions that disrupted safety and predictability in their academic lives. The aim of the study was to verify if and how individual factors (resilience and positivity) and socio-environmental factors (social support and nationality) allow prediction of the level of perceived stress. University students (n = 559) from Poland, Serbia, and Italy were surveyed using the Perceived Stress Scale (PSS-10), the Brief Resilience Scale (BRS), the Positivity Scale (PS), and the Interpersonal Support Evaluation List (ISEL-12). Personal resources-positivity, resilience, and support-were found to be positively interrelated and significantly associated with stress levels. Additionally, gender and nationality differentiated stress levels. A general linear model (GLM) showed that levels of perceived stress are best explained by resilience, positivity, tangible support, and gender. The results obtained can strengthen students' awareness of personal resources and their protective role in maintaining mental health, as well as contribute to the creation of prevention-oriented educational activities. Nationality was not a significant predictor of the level of perceived stress, which highlights the universality of examined predictors among university students from different countries and suggests that interventions aimed at enhancing these resources could benefit students across different cultural contexts.

The psychological well-being of people in a COVID-19 supervised quarantine facility: A mixed methods study

WHAT IS KNOWN ON THE SUBJECT?: Supervised Quarantine has been shown to impact the psychological well-being of those in quarantine both during the COVID-19 pandemic and in previous pandemics. There are few studies regarding the psychological impact of supervised quarantine for the purpose of COVID-19 mitigation. There is little research regarding the psychological well-being of professionals maintaining quarantine, despite the fact they risk potential psychological distress. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper addresses the paucity of knowledge regarding the psychological well-being of those undergoing quarantine in a purpose-built facility. The quarantined study population involved uniquely domestic arrivals and also professionals maintaining quarantine. Lack of control, isolation and miscommunication were perceived as challenging mental well-being. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Although psychological distress in Domestic arrivals appeared low, there are still identifiable stresses on mental well-being. Mental health workers need to be cognizant that point entry to COVID-19 quarantine (Domestic vs. International as well as specific regions) may influence risk of psychological distress. Mental Health nurses supporting those in quarantine should afford quarantined individuals a degree of choice, establish regular clear communication and consider how to establish peer support mechanisms within the quarantine environment.

ABSTRACT

INTRODUCTION: Supervised quarantine may compromise psychological well-being. There is equivocal evidence regarding psychological distress in compulsory supervised quarantine facilities.

AIMS

To evaluate the mental well-being of people undergoing and working in a supervised COVID-19 quarantine facility.

METHOD

Mixed methodology was used, including a cross-sectional analysis of psychological distress (DASS-21) and individual semi-structured interviews (10 professionals maintaining quarantine and 10 quarantined persons).

RESULTS

Overall levels of psychological distress were low. Those quarantining from Victoria had significantly lower depression scores compared to all other departure points. Qualitative analysis identified distress being linked to a lack of control, isolation and miscommunication.

DISCUSSION

Quarantine was associated with low levels of psychological distress. This was lower in people travelling from Victoria, a state where there were higher rates of infections and restrictions. Interviews showed that psychological distress was conceptualized as being associated with supervised quarantine, but participants recognized the overall importance of quarantine.

IMPLICATIONS FOR PRACTICE

Mental health professionals supporting quarantined people should consider original departure points may predict levels of psychological distress. Implementing ways of gaining control through affording choice, improving communication channels and establishing peer support networks within quarantine settings may help maintain mental well-being.

The relationships between anxiety and suicidal ideation and between depression and suicidal ideation among Chinese college students: A network analysis

Background

Suicide is a worldwide public health problem. Evidence from previous studies has confirmed the relationship among anxiety, depression and suicidal ideation. However, the complex psychopathological pathways between anxiety and suicidal ideation and between depression and suicidal ideation require further study.

Methods

A total of 505 college students from Shanghai during COVID-19 pandemic were investigated in an online study. Anxiety, depression and suicidal ideation of the participants were investigated. R software was used to construct the anxiety-suicidal ideation and depression-suicidal ideation networks and to evaluate the bridge expected influences.

Results

The anxiety-suicidal ideation network had 28 cross-community edges, the strongest one was A7 "Afraid something will happen"-S7 "Unable to solve personal problem"; A5 "Restlessness" and S3 "Hopelessness and suicide thoughts" had the highest bridge expected influences. The depression-suicidal ideation network had 36 cross-community edges, and the strongest one was D9 "Thoughts of death"-S5 "Unable to accomplish something important"; D9 "Thoughts of death" and S3 "Hopelessness and suicide thoughts" had the highest bridge expected influences.

Conclusion

Intricate psychopathological pathways exist between anxiety and suicidal ideation and between depression and suicidal ideation. "Restlessness", "Thoughts of death" and "Hopelessness and suicide thoughts" are considered targets for suicidal ideation interventions. The present study enriches the theory of symptoms and mental disorders and provides a reliable reference for the intervention practice of suicidal ideation.

Prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic: A meta-analysis of 113 studies from 31 countries

The purpose of this study was to estimate the prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic. Web of Science (WOS) and PubMed were searched according to a pre-set strategy. A total of 132 studies were identified, 104 of which were included in the meta-analysis. The prevalence of suicidal ideation was approximately 14.7% (95%CI: 12.5%, 16.8%, P < 0.01) in the general population, approximately 22.4% (95%CI: 17.1%, 27.8%, P < 0.01）in adolescents, approximately 21.0% (95%CI: 12.8%, 29.2%, P < 0.01) in psychiatric patients, approximately 20.6% (95%CI: 18.7%, 22.5%, P < 0.01）in university students, approximately 18.9% (95%CI: 8.3%, 29.5%, P < 0.01) in younger adults, approximately 10.6% (95%CI: 1.0%, 20.2%, P = 0.031) in COVID-19 patients and approximately 7.4% (95%CI: 4.3%, 10.5%, P < 0.01) in healthcare workers. The prevalence in North America was approximately 16.0% (95%CI: 13.6%-18.4%, P < 0.001), approximately 14.5% in Asia (95%CI: 9.5%-19.4%, P < 0.001), approximately 10.5% in Europe (95%CI: 8.5%-12.4%, P < 0.001), and approximately 20.5% in South America (95%CI: 19.5%-21.5%, P < 0.001). The following were risk factors which might be correlated with suicidal ideation: severe anxiety symptoms, mild to moderate depression, a strong feeling of loneliness/social isolation, poor sleep quality, having COVID-19-related experience, having quarantine or lockdown experience, being female, being single or divorced, having financial problems and having a history of suicidal ideation/attempt. This article reports the prevalence of suicidal ideation and discussing potential risk factors during the pandemic among general population and vulnerable groups. Early detection and follow-up were necessary for the noteworthy population.

A Repeated Cross-Sectional Pilot Study of Physical Activity, Levels of Depression and Anxiety during the COVID-19 Pandemic in Young Greek Adults

Regular physical activity (PA) and, more specifically, exercise, is associated with lower levels of stress, depression, and anxiety. The aim of this repeated cross-sectional pilot study was to investigate the impact of participating in PA on the mental health of young adults in Greece during the COVID-19 pandemic. The study was carried out during two quarantine periods: Survey I on 5 May 2020, and Survey II on 30 April 2021. The Hamilton Anxiety (HAM-A) and Beck Depression Inventory-II (BDI-II) scales and the level of PA were used to assess a sample of individuals aged between 18 and 26 years old. In 2020 and 2021, a total of 268 (33.9% males) and 380 (37.1% females) subjects participated in the studies, respectively. According to the findings, the vast majority of the participants in both samples reported that they are physically active (p = 0.86), while they consider exercise as a significant health factor (p = 0.10). Moreover, anxiety levels statistically significant increased (p = 0.001), while depression levels remained relatively stable with a slight increase of approximately (p > 0.05). Additionally, in both surveys, individuals who engaged in a PA program exhibited reduced levels of depression and anxiety (p = 0.001). Also, gender appears to influence anxiety and depression levels, while a lack of exercise exacerbates these measures in both genders when compared to physically active individuals. Concludingly, it is crucial for public health strategies to include interventions that promote safe PA in the event of future lockdowns or similar emergencies.

Context-Dependent Responses to the Spread of COVID-19 Among National and International Students During the First Lockdown: An Online Survey

BACKGROUND

Restrictions to minimize social contact was necessary to prevent the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus but may have impacted individuals' mental well-being. Emotional responses are modulated by contextual information. Living abroad during the coronavirus disease 2019 (COVID-19) pandemic may have boosted the feeling of isolation as the context is unfamiliar.

OBJECTIVES

This study compared the psychological impact of social distancing in national students (living in a familiar context) versus international students (living in an unfamiliar context).

METHODS

During March/April 2020 (first lockdown in the Netherlands), 850 university students completed an online survey. Structural equation modeling (SEM) was conducted to compare how students' responses to the virus were predicted by health anxiety, emotional distress, and personal traits.

RESULTS

Compared with national students, international students showed higher levels in 4 identified factors (COVID-19-related worry, perceived risk of infection, distance from possibly contaminated objects, distance from social situations). The factors were mainly predicted by health anxiety across international students, while emotional distress and individual traits (eg, intolerance of uncertainty) played a role across national students.

CONCLUSIONS

In the familiar context, individual characteristics (traits) predicted the responses to the virus, while the unfamiliar context drove individuals' health-focused responses. Living in a foreign country is associated with psychological burdens and this should be considered by universities for more pronounced social support and clear references to health-related institutions.

University students' psychological distress during the COVID-19 pandemic: A structural equation model of the role of resource loss and gain

Using the Conservation of Resources (COR) theory, we aimed to determine whether university students' loss and gain in resources during the pandemic mediated the relationships between COVID-19 exposure/concern and depression and anxiety. In 2021, 7013 Israeli university students completed online questionnaires. We assessed the data using structural equation modeling. We found that resource loss was directly related to concern (β = 0.32, p < 0.001). Depression and anxiety were both directly related to loss of resources (depression: β = 0.75, p < 0.001; anxiety: β = 0.69, p < 0.001) and concern (depression: β = 0.06, p < 0.001; anxiety: β = 0.12, p < 0.001). Resource loss had an indirect effect on the relationships between concern and depression (β = 0.24, p < 0.001) and concern and anxiety (β = 0.22, p < 0.001). COR theory may help explain the mechanisms behind university students' mental health during the pandemic and provides a framework to better understand preparedness for future pandemics, epidemics, and major disasters. Governments and universities should help prevent the loss of resources during future emergencies.

Sleep Quality and Fatigue during Exam Periods in University Students: Prevalence and Associated Factors

The aim of our study was to assess university students' sleep quality and fatigue before and during the academic exam period and identify potential associated factors. A Web-based survey was completed by 940 students of 20 different Tertiary Institutions including demographics, sleep habits, exercise, caffeine, tobacco, alcohol use, subjective sleep quality (Pittsburgh Sleep Quality Index-PSQI), and fatigue (Fatigue severity scale-FSS) at the beginning of the semester and during the examination period. During the exam period, PSQI (8.9 vs. 6.1, p < 0.001) and FSS scores (36.9 vs. 32.7, p < 0.001) were significantly elevated compared to the pre-exam period. An increase in the PSQI score was associated with age (β = 0.111, p = 0.011), presence of chronic disease (β = 0.914, p = 0.006), and depressive symptoms (β = 0.459, p = 0.001). An increase in the FSS score was associated with female gender (β = 1.658, p < 0.001), age, (β = 0.198, p = 0.010), increase in smoking (β = 1.7, p = 0.029), coffee/energy drinks consumption (β = 1.988, p < 0.001), decreased levels of physical exercise (β = 1.660, p < 0.001), and depressive symptoms (β = 2.526, p < 0.001). In conclusion, our findings indicate that exam periods have a negative impact on the sleep quality and fatigue levels of university students. Potential factors were identified that could contribute to the formulation of strategies for improved sleep quality and wellness.

Depression, anxiety, stress, and fear of COVID-19 among Bangladeshi medical students during the first wave of the pandemic: a mixed-methods study

Aim

This study aims to investigate depression, anxiety, stress, and fear of the COVID-19 pandemic and the associated risk factors among Bangladeshi medical students. It also explored qualitative insights on mental health from medical students during the first wave of the pandemic.

Methods

This mixed-methods study was conducted online in Bangladesh from June 2020 to September 2020. Participants were Bangladeshi medical students from the first year to the final year. The quantitative part included a structured online survey. One focus group discussion (FGD) was organized using the Zoom platform to collect qualitative insights from the students. To determine levels of stress, anxiety, and depression, the Bangla-validated version of the Depression, Anxiety, and Stress Scale 21 (DASS-21) was used. A 7-item and Bangla-validated Fear of COVID-19 Scale, also known as FCV-19S, was used to explore the COVID-19-specific fear of the students. A semi-structured topic guide was used for exploring the qualitative insights of medical students' perceptions of fear of COVID-19, mental health impacts during COVID-19, overall recommendations to support students, and the impact of the pandemic on the future of the medical curriculum.

Results

The study reported that 51.20%, 59.40%, and 64% of the 406 respondents had moderate to severe stress, anxiety, and depressive symptoms, respectively, according to the DASS-21. The mean fear score for the COVID-19 scale was 19.4 (SD 6.4). Respondents with family members aged 50 years or older (B = 2.1; CI: 0.3-3.9) and those who had infected family members (B = 1.9; 95% CI: 0.1-3.7) exhibited a higher level of fear of COVID-19. Moreover, depression was associated with a history of having cancer among family members (AOR = 2.9, CI: 1.1-7.5), anxiety was strongly associated with having symptoms of COVID-19 (AOR = 2, CI: 1.3-3.2), and stress was associated with having symptoms of COVID-19 infection among family members (AOR = 1.9, CI: 1.3-3). Altered sleep was a potential risk factor for developing stress, anxiety, and depression symptoms. Manual thematic analysis of qualitative data generated four major themes, including the perception of fear of COVID-19, the perception of mental health impacts during COVID-19, the change in the medical curriculum along with the pandemic, and recommendations from the medical students to support the mental health concerns of medical students during public health crises like this pandemic. Qualitative findings showed that the participants experienced fear of their parents becoming infected by COVID-19, and this fear was more prominent in those who had their loved ones hospitalized. They were also stressed and anxious, with thoughts of death. Their fear also extended to their thoughts on academic progress and the effectiveness of online classes.

Conclusion

A substantial proportion of medical students experienced mental health difficulties in Bangladesh. Appropriate interventions should be designed, and adequate support should be provided to the medical students to protect their mental health and wellbeing, considering their potential impact on the future health system in a low-resource setting like Bangladesh.

Investigating the Role of Second Chance Schools and COVID-19 Pandemic on the Mental Health and Self-Image of Greek Adult Students

COVID-19 has globally impacted both physical and mental health. This study aimed to explore the impact of Second Chance Schools (SCS) and the COVID-19 pandemic on the mental health and self-image of Greek SCS students. A total of 251 SCS students from two consecutive study cycles participated, completing the research instruments at the beginning and end of their studies. Participants' anxiety, depressive symptomatology, well-being, self-esteem and self-efficacy were evaluated by means of the GAD-7, PHQ-8, WHO-5 Well-being Index, Rosenberg Self-Esteem Scale and Generalized Self-Efficacy Scale, respectively. The research spanned three years, including a year of universal lockdown, a year with protective measures and a year without anti-COVID-19 measures. Factor analysis, regression analyses and two two-way repeated measures ANOVAs were applied to the collected data. All five psychological dimensions measured by the study's instruments were grouped into two factors, namely mental health and self-image. Well-being positively influenced mental health, while anxiety and depression had a negative impact. On the other hand, self-efficacy and self-esteem positively contributed to self-image. Mental health and self-image were moderately correlated. Pre-SCS values of mental health and self-image predicted a higher percentage of variance in post-SCS values compared to anxiety, depression, well-being, self-efficacy and self-esteem. Moreover, mental health improved after the completion of SCS, but only for participants after the lifting of anti-COVID-19 measures. Conversely, self-image improved for all participants regardless of the presence of anti-COVID-19 measures. Overall, the SCS had a considerable impact on the participants' mental health and self-image, although the effect was influenced by COVID-19.

University Experience during the First Two Waves of COVID-19: Students' Experiences and Psychological Wellbeing

BACKGROUND

This study aimed to analyze Italian university students' psychological needs, learning experiences, and wellbeing during the first two waves of the COVID-19 pandemic.

METHODS

The study was carried out during the first wave of the pandemic, and then during the second. A total of 1230 university students (654 in stage 1 and 576 in stage 2) completed a battery of validated questionnaires exploring students' experiences in distance learning, perceived health risks related to COVID-19, and psychological wellbeing.

RESULTS

MANOVA showed a significant main effect of the pandemic stage on students' learning experience and wellbeing. In particular, students were more distracted and concerned about their academic careers during the second phase of the pandemic than in the first. Furthermore, the pandemic stage also significantly affected health risk perceptions and fear of COVID-19, which were higher during the second wave of the pandemic. Female gender and concern for a university career were significant risk factors for high levels of negative affectivity and low levels of positive affectivity during the pandemic. In contrast, adherence to COVID-19 restriction measures and good family support were protective factors.

CONCLUSIONS

It is essential to promote adequate university psychological services to support university students who have experienced the adverse psychological effects of the pandemic and enhance the resilience factors needed to improve their wellbeing in the post-pandemic period.

The mental health impact of pandemic COVID-19 crisis on university students in Saudi Arabia and associated factors

INTRODUCTION

New Coronavirus (COVID-19) pandemic has multiple effects. We aimed in this study to assess anxiety, depression, and stress levels among university students in Saudi Arabia and associated factors.

METHOD

We collected 5,140 participations from universities for our cross-sectional study, responders completed the demographic questions, patient health questionnaire 9 (PHQ9) for depression, generalized anxiety disorder 7 (GAD7) for anxiety, and perceived stress scale (PSS) between 24th and 30th of April 2020.

RESULT

80.99% were females and mean age was 21.85 years. 40.8% had significant symptoms of anxiety, 48.8% had significant symptoms of depression, and 86.7% had moderate to high perceived stress. Being Female, younger age, living in eastern region, had a relative or acquaintances with COVID-19, and had chronic medical or mental illness are associated factors with high levels of depression, anxiety, and stress.

DISCUSSION

COVID-19 pandemic negatively affected the mental health of university students. Quick and effective interventions are mandatory.

Profiles and predictors of mental health of university students in Hong Kong under the COVID-19 pandemic

This study investigated the mental health problems of university students in Hong Kong and related sociodemographic and psychosocial predictors under the pandemic. A total of 978 undergraduate students (mean age = 20.69 ± 1.61) completed an online questionnaire measuring sociodemographic factors, psychological morbidity, positive well-being, COVID-19 related stress and self-efficacy, and positive psychosocial attributes. Psychosocial risk factors included psychological morbidity, COVID-19 related stress, and difficulties encountered under the pandemic, whereas protective factors comprised pandemic related self-efficacy, positive psychological attributes, positive environmental factors, need satisfaction and positive perception toward service. Results showed that psychological morbidity in the participants was widespread, and it was related to sociodemographic factors, particularly family financial difficulties. While pandemic related stress positively predicted psychological morbidity and negatively predicted well-being indicators, COVID-19 self-efficacy showed an opposite effect. Besides, positive psychological attributes (resilience, emotional competence, and positive beliefs related to adversity) and environmental factors (healthy family functioning, peer support, and supportive community atmosphere) negatively predicted psychological morbidity and positively predicted well-being. Furthermore, need satisfaction and positive perception toward service were negatively associated with psychological morbidity and positively associated with well-being, while perceived difficulties showed an opposite effect.

Non-lethal suicidal behavior in university students of Spain during COVID-19

Background

Suicide is the fourth external cause of death in the world, in persons between the ages of l5 and 29. The objectives of this study were to measure the prevalence of suicidal behavior in university students and analyze the relationship of suicide risk with psychological distress, resilience, and family and social support.

Methods

An observational and transversal study wherein the students at the University of Malaga (Spain) completed an online questionnaire which included items from different scales, sociodemographic and academic questions, and the subjective impact of the COVID-19 pandemic. Descriptive analyses and prevalence rates of suicidal behavior were calculated, and bivariate analyses, multiple linear regression, and a mediation and moderation analyses were conducted.

Results

A total of 2,212 students completed the questionnaire. The prevalence of the last 6 months was 30.4% wishing for death, 14.7% suicidal ideation, 5% self-harm injuries, and 0.5% suicide attempts. Psychological distress, family and social support were linked to the risk of suicide. Lastly, resilience and family support measure and moderate the relation between psychological stress and suicide risk.

Conclusion

Psychological distress is a risk factor for suicidal behavior, while resilience and family and social support are linked to a lower risk of suicide.

Mental distress and well-being of university students amid COVID-19 pandemic: findings from an online integrative intervention for psychology trainees

Introduction

University students have been severely affected by the COVID-19 pandemic, as significant changes supervened their academic and social life. To tackle these challenges, several adjustments in the educational methods may be warranted for cultivating a positive environment at higher education institutions. The aim of this study was to investigate the risk and protective factors of students' mental health and well-being as well as their potential for flourishing in an undergraduate clinical psychology course that took place online due to the COVID-19 restrictive measures and incorporated positive psychology exercises as a means to empower young people amid the adverse conditions of the lockdown.

Methods

In total, 124 students attended the course and completed mental health (i.e., DASS-9, HADS, ERQ) and well-being (i.e., MHC-SF, SWLS, PANAS, GQ-6, BRS) measures at two time points (pre-and-post-test), during the first restrictions in Greece (March-June 2020).

Results

According to the results, students aged 18-20 years old reported higher levels of stress [χ² = 14.72, p = 0.002], while students who felt that the quality of their studies had deteriorated [χ² = 6.57, p = 0.038] reported increased levels of anxiety. High levels of depression were correlated with worse relationships with significant others (z = 7.02, p = 0.030 and χ² = 11.39, p = 0.003 for family and friends, respectively), while gratitude and resilience were positively correlated with improved relationships with others, both during and after the lockdown. Factors associated with students' well-being were satisfaction with life and gratitude.

Discussion

These results suggest that well-being enhancement factors may have added value to current educational practices for promoting students' mental health and well-being in times of crisis.

A RE-AIM Analysis of a Mental Health App for Undergraduate and Medical Students during the COVID-19 Pandemic: A Retrospective Cross-Sectional Study

OBJECTIVE

The purpose of this study was to use the RE-AIM framework to evaluate the implementation of a mental health app designed for undergraduate and medical students during the COVID-19 pandemic.

PARTICIPANTS

Medical (n = 270) and undergraduate students (n = 1386) from five universities in the Appalachian region in the United States participated in this study.

METHODS

Universities from the United States were recruited to deploy the Sharpen app for medical and undergraduate students. The Sharpen app provided psychoeducational modules in mental health literacy, social-emotional learning, mindfulness-based stress reduction, and suicide prevention to promote protective factors for students. The utilization of the Sharpen app was analyzed using the RE-AIM framework using a retrospective, cross-sectional design.

RESULTS

Reach: A total of 12.72% of medical students and 6.00% of undergraduate students participated in the study.

EFFICACY

Medical students viewed significantly more pages, had a significantly higher unique page view average, and a statistically significant exit percentage when compared to undergraduate students. Adoption: A total of 100% of the universities that were recruited participated in the study.

IMPLEMENTATION

Five out of six implementation criteria were included, indicating high implementation. Maintenance: All of the universities continued using the Sharpen app following the end of data collection, resulting in a 100% maintenance rate.

CONCLUSIONS

The RE-AIM framework indicated usability and maintenance by medical and undergraduate students. Future research needs to implement a more rigorous design to determine the impact of the Sharpen app on mental health outcomes in medical and undergraduate students.

Implications of the COVID-19 Pandemic for the Well-Being of Emerging Adult Populations: A Synthesis of Findings From the COVID-19 Eating and Activity Over Time (C-EAT) Study

Research addressing the impact of the COVID-19 pandemic on psychosocial well-being and health behavior is accumulating; however, implications for emerging adult populations are underexplored. This manuscript synthesizes findings from a mixed-methods study of well-being, eating and activity behaviors, and food insecurity among a diverse, longitudinal cohort of emerging adults. The review includes findings from 11 original studies that involved collecting online surveys from 720 emerging adults and in-depth, virtual interviews with 33 respondents who were food insecure. Findings indicated the pandemic had widespread impacts on well-being. Population groups at greatest risk for poor outcomes included women; those who identified as Black, Indigenous, or a Person of Color; persons in households of low socioeconomic status; parents of young children; and persons who previously experienced mental health challenges or weight stigma. Further research will be needed to evaluate efforts to improve the well-being of emerging adults in the aftermath of the pandemic.

Linguistic markers of processing the first months of the pandemic COVID-19: a psycholinguistic analysis of Italian university students' diaries

A longitudinal psycholinguistic study was conducted with 107 students from different Italian universities that produced daily photo-diary entries for two weeks, one at the beginning and the other at the end of the first Italian lockdown period, imposed in view of the rapid dissemination of COVID -19. The task was to take a daily photo accompanied by a short description (text). The texts accompanying the photos were analysed using Linguistic Inquiry and Word Count (LIWC) software to analyze linguistic markers representing psychological processes related to the experience of the pandemic and the lockdown, identifying potential changes in psycholinguistic variables useful for understanding the psychological impact of such harsh and extended restricted living conditions on Italian students. LIWC categories related to negation, anger, cognitive mechanisms, tentative discourse, past, and future increased statistically significantly between the two time points, while word count, prepositions, communication, leisure, and home decreased statistically significantly. While male participants used more articles at both time points, females used more words related to anxiety, social processes, past, and present at T1 and more related to insight at T2. Participants who lived with their partner showed higher scores on negative emotions, affect, positive feelings, anger, optimism, and certainty. Participants from southern Italy tended to describe their experiences from a collective and social perspective rather than an individual perspective. By identifying, discussing, and comparing these phenomena with the broader literature, a spotlight is shed for the first time on the psycholinguistic analysis of students at the national level who faced the first COVID -19 lockdown in Italy.

Mental health state and its determinants in German university students across the COVID-19 pandemic: findings from three repeated cross-sectional surveys between 2019 and 2021

Background

Students were at an increased risk for elevated mental symptoms during the first year of the COVID-19 pandemic compared to pre-pandemic levels. As universities remained closed much longer than anticipated, the mental burden was expected to persist through the second year of the pandemic. The current study aimed to investigate the prevalence of mental distress from 2019 through 2021 and identify risk factors for elevated mental burden, focusing on gender.

Methods

We analyzed three cross-sectional online surveys among students at the University of Mainz, conducted in 2019 (n = 4,351), 2020 (n = 3,066), and 2021 (n = 1,438). Changes in the prevalence of depressive symptoms, anxiety, suicidal ideation, and loneliness were calculated using Pearson's chi-square tests and analyses of variance. Multiple linear regressions yielded associated risk factors.

Results

The proportion of students with clinically relevant depressive symptoms was significantly higher during the pandemic (38.9% in 2020, and 40.7% in 2021), compared to pre-pandemic (29.0% in 2019). Similarly, more students reported suicidal ideation and generalized anxiety during the pandemic with a peak in the second pandemic year (2021). The level of loneliness was significantly higher in 2020, compared to 2019, and remained at a high level in 2021 (p < 0.001, η p 2 = 0.142). Female and diverse/open gender, being single, living alone, and being a first-year student were identified as risk factors associated with mental burden during the pandemic.

Discussion

Mental burdens remained elevated among students through the second year of the pandemic and were associated with socio-demographic risk factors and pandemic-related concerns. Future research should monitor recovery and evaluate the need for psychosocial support.

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

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

How are Brazilian university students coping with the COVID-19 pandemic? Results of an online survey on psychosocial well-being, perceived burdens, and attitudes toward social distancing and vaccination

BACKGROUND

The COVID-19 pandemic caused significant disruption to education systems worldwide, increasing pre-existing concerns regarding university students' mental health. Brazil was among the countries most affected by COVID-19 cases and deaths and was considered a pandemic epicenter. This study aimed to investigate Brazilian university students' mental health status and perceived burdens during the COVID-19 pandemic.

MATERIAL AND METHODS

From November 2021 to March 2022, a cross-sectional and anonymous online survey was conducted among students of a Brazilian federal university. Mental health status (depressive symptoms, alcohol and drug consumption) and social and emotional aspects in the pandemic context (social support, perceived stress, loneliness, resilience, and self-efficacy) were assessed with standardized measures. Students' attitudes toward the COVID-19 pandemic and vaccination and perceived burdens of the pandemic were also investigated.

RESULTS

A total of N = 2,437 students completed the online survey. The PHQ-9 mean sum score was 12.85 (SD = 7.40), while n = 1,488 (61.10%) participants reported a sum score of 10 or more, indicating clinically relevant depressive symptoms. Further, n = 808 (33.1%) of the total sample reported suicidal thoughts. Levels of depressive symptoms, perceived stress, and loneliness were higher among undergraduate/bachelor students than doctoral students. Almost all participants (97.3%) reported being fully vaccinated against COVID-19. Multiple regression analyses showed that being single, having an income decreased during the pandemic, having a previous mental illness, having a chronic somatic condition, not finding positive aspects in the pandemic, lower self-efficacy, lower social support, lower resilience, and higher experienced loneliness were significantly associated with higher levels of depression.

CONCLUSIONS

The study showed high levels of depressive symptoms and suicidal ideation among Federal University of Parana students. Therefore, health care providers and universities need to recognize and address mental health issues; psychosocial policies must be enhanced to mitigate the impact of the pandemic on students' mental health and wellbeing.

COVID-19 and Sleep Disturbances: A Literature Review of Clinical Evidence

The need for adequate good quality sleep to optimally function is well known. Over years, various physical, psychological, biological, and social factors have been investigated to understand their impact on sleep. However, understanding the etiological processes that are involved in causing sleep disturbances (SD) as impacted by stressful phases such as pandemics has not been well studied. Many such etiological and management strategies have surfaced during the latest "coronavirus disease of 2019 (COVID-19) pandemic. The occurrence of these SD in the infected and uninfected individuals poses a need to investigate factors linked to such occurrence during this phase. Some of such factors include stressful practices such as social distancing, masking, vaccines, and medications availability, changes in routines, and lifestyles. As the status of infection improved, a collective term for all the prolonged effects of COVID-19 after the resolution of the primary infection called the post-COVID-19 syndrome (PCS) surfaced. Apart from impacting sleep during the infectious phase, the aftereffects of this virus left an even greater impact during the PCS. Various mechanisms have been hypothesized to be linked to such SD during the PCS, but the available data are inconclusive. Further, the varied patterns of incidence of these SDs differed by many factors, such as age, gender, and geographical location, making clinical management even more challenging. This review elucidates the impact of coronavirus 2 (SARS-CoV-2) (COVID) disease on sleep health during the various phases of the COVID-19 pandemic. We also investigate different causal relationships, management strategies, and knowledge gaps related to SD during the COVID-19 pandemic.

Faculty and students’ perspectives of online learning during COVID-19 crisis: Constraints and opportunities for Kenyan universities

At the onset of COVID-19 pandemic, all higher education institutions had to abruptly migrate from face-to-face mode of learning to virtual learning. Students and faculty members were thrown into the process of acquainting themselves with a fully virtual system. How prepared were institutions, faculty members, and students for the abrupt and massive transition to online learning? The study examined the faculty and students’ perspective of online learning during COVID-19 pandemic. Specifically, the study examined the perceptions of faculty and students on the preparedness of higher education institutions for online teaching and learning. The study also determined the perceptions of staff and students towards online education, constraints, and opportunities. A descriptive cross-sectional survey was conducted at a public university in Kenya. A semi-structured interview was conducted on a total sample of 36 respondents; 24 students and 12 faculty members to capture unique, idiosyncratic and whole individual viewpoints. A conventional Content Analysis was done to determine words or concepts within the transcripts. The findings showed that the study institution, faculty members, and students were unprepared for the immediate and massive shift to online teaching and learning and had challenges using virtual technologies for teaching and learning during the lockdown. These challenges ranged from insufficient or lack of internet bandwidth, training, increased teaching and learning workloads to limited time for interactions. Based on the findings, the study suggests significant implications for higher education institution leaders, policymakers, faculty, and students. The study contributes to the existing literature by analyzing the perceptions of faculty and students about the preparedness of institutions, faculty, and students on the abrupt shift to online learning during the COVID-19 pandemic.

Forced social isolation and lockdown during the COVID-19 pandemic: depression, anxiety, trauma-distress and coping mechanisms of a Greek sample

Aim

The COVID-19 outbreak escalated into a global pandemic, pushing many governments around the world to impose measures affecting all aspects of life. Similar to other countries, Greece adopted social restriction, lockdowns, and quarantines to reduce transmission from person-to-person. This cross-sectional study investigated the association between social restriction measures, an mental health and coping strategies employed by a Greek adult sample.

Subject and methods

An online questionnaire was used to collect data during the second national lockdown (February to May 2021). A total of 650 participants (M age 33.13, 71.5% female) comprised the final sample.

Results

The results show 21.3% of respondents reported moderate-to-extremely severe anxiety, 33% moderate-to-extremely severe depression, 31.8% moderate-to-severe stress, and 38% clinically significant trauma-related distress. Hierarchical linear regression analyses revealed that the strongest contributors to adverse mental health outcomes were being female, of younger age, experiencing increases in verbal arguments at home, being separated from family and close friends, and being unable to afford enough or healthy food. Lastly, participants reported moving away from social support and into more individual strength and resilience-based coping strategies to cope with challenges.

Conclusion

These findings suggest that in addition to the detrimental effects on physical health, social restriction measures related to COVID-19 also imposed a heavy psychological burden on the population via forced social isolation, which, by design, increased not only physical distancing but also psychological distancing between people.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-023-01907-3.

Effects of Health Anxiety, Social Support, and Coping on Dissociation with Mediating Role of Perceived Stress during the COVID-19 Pandemic

BACKGROUND

Our study aimed to examine whether health anxiety, social support, and ways of coping relate to dissociation directly or only through the mediation of perceived stress, moderated by the time of measurement (lockdown). We investigated the effect of perceived stress on different forms (sub-scales) of dissociation.

METHODS

A cross-sectional survey was conducted by an online form at two points in time: the beginning and the later stage of the COVID-19 pandemic.

RESULTS

We received a total of 1711 responses. Perceived stress moderately correlated with dissociation in both international and Hungarian samples. Health anxiety showed a strong direct and indirect correlation with dissociation. Regarding social support, the support of family significantly decreased the dissociative experiences in the Hungarian sample mediated by perceived and direct stress. In the international sample, goal-oriented coping strategies strongly decreased all dissociation scales in the first measurement, through the mediation of perceived stress. As for the Hungarian sample, positive thinking was found to decrease dissociation by decreasing perceived stress.

CONCLUSION

health anxiety, coping, and social support appeared to influence dissociation directly and through the mediation of perceived stress. Social support, mainly support of the family and problem-focused coping strategies may decrease the level of stress, this way decreasing dissociative behavior.

Academic burnout among master and doctoral students during the COVID-19 pandemic

The COVID-19 outbreak has had an immense impact on academic life and public health. Graduate students had experienced obligatory curfews and quarantines due to the COVID-19 outbreak directly impacting their mental health and triggering academic burnout. In this cross-sectional study, we address the issue of mental health in graduate students by relating it to the factors associated with burnout syndrome during the COVID-19 pandemic. A total of 519 graduate students from master's and Ph.D./DLA degrees across universities in Hungary and other European countries participated in this study. The Copenhagen burnout inventory student version was used to evaluate burnout syndrome as an outcome. Our findings displayed burnout significantly lower among graduate students who had good sleep quality, receive high levels of support from their university, and were satisfied with how their university dealt with the pandemic. The excessive consumption of alcohol, the use of antidepressants, being single, and thinking about dropping out showed as predictive factors of burnout. The results add to emergent evidence on the impact of the COVID-19 pandemic on mental health and the predicted factors of academic burnout among master and doctoral students.

Promoting Emotional and Psychological Well-Being During COVID-19 Pandemic: A Self-Help Virtual Reality Intervention for University Students

Mental health problems are very common among university students, and the situation worsened during the COVID-19 pandemic. The closure of universities, the restrictions imposed, and the reduction of social activities led to considerable changes in students' lives, thus posing new mental health and emotional challenges. Within this context, promoting university students' general well-being, in particular emotional and psychological well-being, becomes essential. In addition to the possibility of online interventions aimed at overcoming distance limitations and reaching people at their home, other advanced technologies such as virtual reality (VR) have demonstrated the potential to improve people's well-being, quality of life, and positive experiences. The study reported in this article is aimed at exploring the feasibility and preliminary effectiveness of a self-help VR intervention lasting 3 weeks in promoting emotional well-being in university students. Forty-two university students voluntarily participated in a six-session intervention. In each session, a different virtual scenario was presented: two relaxing experiences and four transformative experiences based on metaphors or metaphoric ones aimed at encouraging students to be aware of their emotions and positive resources. Students were randomly allocated to an experimental group and to a waiting list group that started the intervention after 3 weeks. Before and after the six sessions, participants completed an assessment by completing online questionnaires. Results showed a significant increase in both emotional well-being and psychological well-being in the experimental group compared to the waiting list group. The majority of participants said that they would recommend the experience to other students.

Self-Compassion and Well-Being during the COVID-19 Pandemic: A Study of Greek College Students

The present study examined the relationship between self-compassion (SC) and emotional well-being in college students during the COVID-19 pandemic. The theoretical framework for the study was that SC, defined as an understanding and caring response to one's suffering and limitations, may serve as a protective factor against negative mental health outcomes. A sample of college students (N = 101) completed self-report measures of SC, depression, anxiety, stress, life satisfaction and subjective happiness. Data were analysed using regression analysis to examine the prediction of emotional well-being variables by SC and moderation analysis to examine the moderating effect of SC on the relationships between emotional well-being variables. The study's results confirmed the hypothesis that SC would predict emotional well-being. SC significantly predicted all variables examined, including depression, anxiety, stress, life satisfaction (LS) and subjective happiness (SH). However, SC did not moderate the relationships between these variables. Isolation significantly moderated the relationship between SH and depression among college students. These findings support the idea that SC may serve as a protective factor against negative mental health outcomes and suggest that interventions aimed at increasing SC may improve mental health and overall well-being in college students during the COVID-19 pandemic. Further research is needed to understand these relationships' mechanisms and the factors that may influence them.

Changes in suicide-related indices at a student counseling center at a Japanese University before and after COVID-19

Suicides by university students in Japan have increased with the onset of the COVID- 19 pandemic. Changes in the suicidality of clients in student counseling centers are unknown. We compared OQ 45.2, suicidal risk, and suicidality before and after the pandemic, testing 1801 clients at the Student Counseling Center of University A in Japan. The post-group exhibited significantly decreases in all suicide-related indices. Results reveal that fewer students may feel suicidal and that the number of consultations with suicidal students may have decreased. It is important to build support systems easier for students to access in crises and alone.

Can Views and Contact with Nature at Home Help Combat Anxiety and Depression during the Pandemic? Results of the GreenCOVID study

BACKGROUND

The COVID-19 pandemic and the lockdown measures have had important consequences on the mental health of the population, although little is known about the role played by nature and its benefits.

OBJECTIVES

The present study aims to evaluate the risk of anxiety and depression during the first wave of the COVID-19 pandemic in Spain and to identify the factors most strongly associated with anxiety and depression, including sociodemographic, household characteristics, and access to or contact with natural environment.

METHODS

GreenCOVID is an online cross-sectional study promoted by the Health & Territory Research (HTR) of the University of Seville in Spain, Maynooth University in Ireland, and the University of Winchester in the United Kingdom. This study includes only data from Spain which were collected between April 8, 2020 and April 27, 2020. Binary logistic regression was conducted to identify the factors associated with anxiety and depression through the HADS scale.

RESULTS

Of the total of 2,464 adults who participated in GreenCOVID Spain, mean age was 38.1 years, 72.6% were female, 58.1% were at risk of anxiety, and 32.3% of depression. In the multivariable logistic regression, the factors associated with risk of anxiety were female: gender, being a student and problems at home. Regarding the risk of depression, the factors most associated were being a student, female gender, problems at home, worse evaluation of views from home and less help from outside views to cope with lockdown.

CONCLUSIONS

Our findings show that during COVID-19 pandemic, in addition to sociodemographic factors female gender and being a student, problems at home, lack of natural elements in the home, and worse appreciation of views from home were associated with mental health problems. Thus, housing conditions and access to the natural environment were important for mental health during COVID-19 lockdown.

Fear of COVID-19, death depression and death anxiety: Religious coping as a mediator

The COVID-19 pandemic has affected the well-being and mental health of populations worldwide. This study sought to examine whether religious coping mediated the relationship between COVID-19-related fear and death distress. We administered an online survey to 390 adult participants (66.15% females; Mage = 30.85 ± 10.19 years) across Turkey. Participants completed a series of questionnaires measuring the fear they had experienced during the COVID-19 pandemic, their levels of religious coping and their levels of death anxiety and depression. Our findings revealed that (a) fear of COVID-19 was associated with positive religious coping, negative religious coping, death anxiety and death distress; (b) negative religious coping was associated with death anxiety and depression and (c) negative religious coping mediated the relationship between fear of COVID-19 and death anxiety and depression. These results highlight the detrimental effect of negative religious coping in increasing the adverse effect of the COVID-19 fear on death depression.

Pre- and Post-Pandemic (COVID-19) Mental Health of International Students: Data from a Longitudinal Study

Purpose

International students are highly vulnerable to the risk of mental health worsening before and during the pandemic (COVID-19). This study investigated international students' mental health pre- and post-pandemic (COVID-19).

Methods

It is a longitudinal study, and data were collected online, pre-pandemic (N = 470) and during the pandemic (N = 420). Using a random sampling technique, a self-administered questionnaire was used to measure mental health, including depression and anxiety.

Results

Findings show that international students' mental health was good in pre-pandemic. Meanwhile, international students were found to be more depressed and anxious during the pandemic. Findings also investigated that in the pre-pandemic phase, young students' and mainly females' mental health was worsened.

Conclusion

This study concluded that students' mental problems are alarming, so the university should provide psychological services for the student's mental health. Post-pandemic is leaving long-lasting psychological effects and will require further investigation.