US college student mental health and COVID-19: Comparing pre-pandemic and pandemic timepoints

Cognitive distortions as a mediator of the relationship between dispositional mindfulness and psychological distress among college students

OBJECTIVE

This study examined the mediating role of cognitive distortions (CDs) in the relationship between dispositional mindfulness (DM) and psychological distress, and considered gender as a potential moderator of these mediation models.

PARTICIPANTS

Four hundred and forty-six college students (63.9% female; M = 20.52 years; 87.4% undergraduate, 12.6% graduate level) participated.

METHODS

Self-report measures of DM, CDs, anxiety, depression, and perceived stress were completed with data collected from April to October of 2020.

RESULTS

Females scored significantly higher than males on anxiety, depression, perceived stress, and CDs. CDs partially mediated the relationship between DM and all psychological distress variables. Gender moderated the mediation model predicting anxiety, with the indirect effect of DM on anxiety via CDs being stronger for females than males.

CONCLUSION

Results support CDs as a possible mechanism underlying the association between DM and psychological distress with implications for targeting cognitive patterns in mindfulness-based interventions with college students.

The moderating effects of intolerance of uncertainty and social connectedness on college students' addictive behaviors and mental health symptoms during the COVID-19 pandemic

Objective: This study aimed to understand COVID-19 pandemic impacts on anxiety, depression, and addictive/excessive behaviors, with exploration of intolerance of uncertainty (IU) and social connectedness as potential moderators. Participants: Adult college students participated. Method: Our online survey assessed symptoms and behaviors prior to COVID-19, during the initial outbreak (Wave 1), and during early 2021 (Wave 2). Results: Significant increases were found in anxiety, depression, binge eating, sexual behaviors, video game playing, internet/social media usage, and compulsive exercise in both waves. IU moderated the relationship between both depression/anxiety and certain excessive behaviors; social connectedness moderated the relationship between anxiety and smoking. Conclusions: This study replicated prior work and highlights new impacts on addictive/excessive behaviors, as well as moderating effects from social connectedness and IU. Future research is warranted to evaluate the efficacy of treatments targeting IU and social connectedness as the pandemic continues to unfold.

The relationship between health-promoting behaviors and negative emotions in college freshmen: a cross-lagged analysis

Background

The prevalence of mental health issues has been gradually increasing among college students in recent years. Improvements in mental health can be achieved through changes in daily behavior and the use of psychological counseling. This study aims to investigate the relationship between health-promoting behaviors and negative emotions among college freshmen as they enter the university. It also examines the impact of various sub-dimensions of health-promoting behaviors and other factors on the negative emotions (stress, anxiety, and depression) experienced by college freshmen.

Methods

Using the Negative Emotion and Health-Promoting Behavior scales, a 7-month longitudinal study was conducted on 4,252 college freshmen, with collection of data at two time points (T1: November 12, 2021; T2: June 17, 2022). Out of this longitudinal study, 3,632 valid samples were obtained. This research aimed to explore the association and impact between negative emotions and the level of health-promoting behaviors among college students during their time at the university.

Results

① There were significant differences in the levels of health-promoting behaviors and negative emotions over the course of 7 months (P < 0.05). Health-promoting behaviors were found to have a significant negative correlation with negative emotions (P < 0.05). ② Negative emotions at T1 significantly negatively predicted health-promoting behaviors at T2 (β = -0.11, P < 0.01), while health-promoting behaviors at T1 significantly negatively predicted negative emotions at T2 (β = -0.12, P < 0.001). ③ Stress management (β = -0.104, P < 0.05; β = -0.087, P < 0.05), self-actualization (β = -0.282, P < 0.01; β = -0.260, P < 0.05), health responsibility (β = -0.057, P < 0.05; β = -0.088, P < 0.05), and interpersonal relations (β = 0.068, P < 0.01; β = 0.138, P < 0.05) were important components in improving stress and anxiety. Self-actualization (β = -0.437, P < 0.001), exercise (β = 0.048, P < 0.001), nutrition (β = 0.044, P < 0.001), and interpersonal relations (β = 0.065, P < 0.001) were important components in improving depression. ④ Gender, place of household registration, and whether the individual is the only child were significant factors affecting negative emotions in college freshmen.

Conclusion

The level of health-promoting behaviors is an important indicator for assessing the negative emotional states of college freshmen. Enhancing health-promoting behaviors across various dimensions can help alleviate different types of negative emotions. Gender, place of household registration, and being the only child are significant factors that influence negative emotions.

Coping strategy-situation fit vs. present control: relations with perceived stress in U.S. college students

BACKGROUND

According to the strategy-situation fit hypothesis, it is adaptive to match coping strategies to the controllability of stressors. Although early research generally supported this hypothesis, recent findings have been inconsistent. The goals of this study were to test the strategy-situation fit hypothesis, addressing limitations of past research, and compare it to an alternative hypothesis from the temporal model of control (i.e., to focus on what one can control rather than matching coping strategies to control appraisals).

DESIGN AND METHODS

College students (n = 159) completed measures assessing their stressors, coping strategies, stressor controllability, perceived control over present aspects of stressors, and perceived stress. Data were collected via online surveys in Fall 2020.

RESULTS

Consistent with the strategy-situation fit hypothesis, using a higher ratio of problem-solving coping for more controllable stressors was associated with less stress. However, using more emotion-focused coping for less controllable stressors was not associated with less stress. In addition, focusing on what one could control in the present was associated with less stress, above and beyond strategy-situation fit.

CONCLUSIONS

It may be more adaptive to focus on what one can control in the present than to match coping styles to stressor controllability.

The association between the sense of control and depression during the COVID-19 pandemic: a systematic review and meta-analysis

Introduction

High levels of depression and low sense of control have been reported during the COVID-19 pandemic. The removal of typical freedoms through public health restrictions may have played an important role. The aim of this review was to examine data collected during the pandemic and (1) estimate the strength of the association between sense of control and depression, (2) examine whether the different types of control measures affected the strength of the association, and (3) whether this changed as a function of pandemic indicators.

Methods

We conducted a systematic review and meta-analysis of studies published in English between December 2019 and November 2022. A total of 993 articles were identified, of which 20 were included in the review and 16 in the meta-analysis after conducting a quality assessment using the standard NIH tool.

Results

The control-depression association gave a bias-independent pooled effect size of r = .41, and grew stronger over the 130 weeks covered by this review but did not change as a function of local COVID incidence rates. Subgroup analyses showed that external and overall control were more strongly related to depression than internal control.

Discussion

These findings emphasize that external factors are important to the sense of control and the importance of preserving the sense of control in situations where the removal of personal freedoms is necessary, such as public health emergencies.

Association of perceived stress and sleep quality among medical students: the mediating role of anxiety and depression symptoms during COVID-19

COVID-19 has intensified the influence on medical students by changing the lifestyle, online study and clinical practice which bring out series of stress, sleep disturbance and mental health problems. This cross-sectional study aim to explore the association between perceived stress and sleep quality among medical students and investigated whether anxiety and depression mediated this association during pandemic. A total of 1,021 medical students in two universities who were from Guangdong Province, China participated this study and from January to September 2020 through the online question are, with 28.80% reporting sleep disturbances. The medical students were finished various self-reported questionnaires, including the Perceived Stress Scale-10, Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder-7 Scale, and Patient Health Questionnaire-9, the study found positive correlations among sleep quality, perceived stress, anxiety, and depression. The data was analyzed with The Amos 26.0 system. Result demonstrated that perceived stress was associated with poor sleep quality. Anxiety and depression partially mediated the association between perceived stress and poor sleep quality, explaining 73.08% of the association. This study's structural equation model offers a useful framework for assessing mechanisms mediating associations between perceived stress and sleep quality. The findings emphases the importance of addressing psychological factors in high-pressure situations, which can exacerbate sleep disturbances among medical students. It is important to screen the level of stress, mental health problems and investigate the risk factors of sleep quality among medical students during emergency public health events.

Factors affecting COVID-19's mental health impact on college students in the southeastern United States

Emerging evidence confirms COVID-19's negative impact on college students' mental health; however, more research is needed to identify factors that promoted or hindered college students' mental health early in the pandemic. This exploratory study addressed this need. Participants were 697 students attending a large, state, urban university in the southeastern United States. Using a cross-sectional survey design, participants completed an anonymous, online survey assessing socio-demographic variables, mental health issues, and activities during the lockdown period in 2020. Findings suggest college students in the southeastern US who were women or transgender men and had pre-existing mental health conditions, fewer routine activities, and high exposure to COVID-19 news reported more mental health problems early in the pandemic. Students who exercised daily had fewer symptoms of anxiety and post-traumatic stress than students who exercised monthly, but there were no differences in emotional responses to COVID-19 based on exercise frequency. Tailored strategies to address college students' needs in response to the current or future pandemics are needed and should take into consideration factors that promote or hinder mental health. Patient or Public Contribution: College students were participants in this study. College students who were not participants in this study assisted with the implementation of this study.

The effect of acceptance and commitment therapy on the psychological flexibility and inflexibility of undergraduate students: A systematic review and three-level meta-analysis

Rising rates of mental health problems in undergraduate students is a critical public health issue. There is evidence supporting the efficacy of acceptance and commitment therapy (ACT) in decreasing psychological symptoms in undergraduates, which is thought to be facilitated through increases in psychological flexibility (PF) and decreases in psychological inflexibility (PIF). However, little is known about the effect of ACT on these processes in undergraduates. We conducted a systematic review and three-level meta-analysis examining this effect in 20 studies, which provided 56 effect sizes. A combined sample of 1,750 undergraduates yielded a small-to-medium overall effect (g = .38, SE = .09, p < .001, 95% CI: [0.20, 0.56]). This effect did not depend on control group type, intervention modality, number of sessions, the questionnaire used, whether PF or PIF was measured, or participant age. However, there was a significant mean effect only in studies with a specific clinical target, but not in those without one. Furthermore, the higher the percentage of female participants, the lower the reported effect size. Results suggested that ACT may increase PF and decrease PIF in undergraduates and highlighted various conceptual and measurement issues. Study protocol and materials were preregistered (https://osf.io/un6ce/).

A longitudinal study of US college students before and during the Covid-19 pandemic

OBJECTIVE

To assess the Covid-19 pandemic's effects on college students' stress, life satisfaction, and college experiences and investigate sources of resilience.

PARTICIPANTS

1,042 students from 11 U.S. colleges and universities.

METHODS

Longitudinal study with surveys in winter 2018-2019 and fall 2021. Interviews with 54 survey respondents, spring 2021. Surveys measured purpose, social agency, goal-directedness, belonging, positive relationships, stress, life satisfaction, and pandemic impact. Interviews explored students' experiences during the pandemic.

RESULTS

Stress increased, and life satisfaction decreased from T1 to T2, but only for those with the highest reported pandemic impact, not in the sample overall. Goal-directedness, social agency, positive relationships, and sense of belonging were associated with lower stress and higher life satisfaction at both time points. Interviewees described both challenges and "silver linings" resulting from the pandemic.

CONCLUSIONS

Single time-point studies of students' pandemic experiences may overstate the pandemic's negative mental health consequences and underestimate students' resilience.

Impact of COVID-19 pandemic on sleep of undergraduate students: A systematic literature review

The 2019 coronavirus pandemic forced the shift to distance education aggravating mental and physical vulnerabilities of undergraduate students, including sleep. This review aims to describe sleep problem rates and prevalence, sleep pattern disruption, sleep duration, sleep quality, insomnia symptoms, psychological and socio-economic factors affecting sleep of undergraduates in 22 countries. A systematic search for articles published from 2020 to 2021 using 'COVID-19,' 'Coronavirus,' 'Pandemic,' 'Sleep,' 'Mental Health,' and 'Students' from PubMed, Scopus, and Cochrane yielded 2550 articles, where 72 were included. Selection criteria were: English full-text available articles, undergraduates and not postgraduates, reported sleep outcomes, and participants not from allied health courses. Risk of bias was assessed using various Joanna Briggs Institute checklists and outcomes were descriptively synthesized. Prevalence of sleep problems was notable, while longitudinal studies showed increased rates. There was significantly increased sleep duration, and sleep pattern disruption during lockdowns. Several psychological, behavioural, environmental, demographic, and socio-economic factors were found to be associated with sleep changes. These highlight the pandemic's impact on sleep of undergraduate students and reveal opportunities for institutions to intervene with policies and programs to promote the well-being of undergraduates. Limitations include recall bias and underrepresentation of other countries. This study is self-funded with registration number RGAO-2021-0071.

Association between attitudes toward the COVID-19 vaccines and mental health among 140,259 college students in China

Background

With the launch of the COVID-19 vaccines, the vaccination rate has become a hot issue of concern. However, the evidence for the relationship between college students' attitudes toward vaccines and anxiety and depressive symptoms has been limited.

Methods

In total, 140,259 college students were recruited using a cluster sampling method in Zhengzhou, Xinxiang, Xinyang city of Henan Province, China, May 21-27, 2021. Anxiety symptoms were determined by the Generalized Anxiety Disorder tool (GAD-7) and depressive symptoms were determined by the Patient Health Questionnaire (PHQ-9). Multiple logistic regression was performed to estimate the association between students' attitudes toward the vaccines and anxiety and depressive symptoms.

Results

The results indicate that 22.45% of students are unclear whether the vaccine can protect them from infection and 45.57% are unclear whether the vaccine is safe and has no side effects. In addition, after adjusting, the model showed that students who think vaccines can protect them and are safe had 0.128 (95%CI 0.110-0.150; Ptrend < 0.001) times lower risk of anxiety compared to their counterparts who think vaccines can neither protect them nor are safe. Similar ORs were found in depression (aOR = 0.157; 95%CI 0.137-0.180).

Conclusion

This large-scale study has shown an association between symptoms of anxiety and depression and reluctance to obtain vaccination.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-023-01830-7.

The COVID-19 pandemic: Electronic media use and health among US College students

Objective: To explore differences before and during the COVID-19 pandemic in electronic media use (i.e. TV watching, social media use, screen time), health (i.e. physical, behavioral, social, mental), and the relationship between them among college students. Participants: Nine hundred sixty-five United States college students with 367 participating before and 598 during the pandemic (after March 2020). Methods: Using a multiple cross-sectional design, participants completed an online self-report questionnaire and biometric data was gathered in-person for the Pre-COVID group. Results: During the pandemic, time spent watching TV and social media was 14% higher and total screen time was 30% higher (d = .39). Health variations were mixed with both adverse and beneficial differences. Most correlations between electronic media use and health variables were lower in strength during the pandemic. Conclusions: Differences between electronic media use and health before and during the pandemic suggest potential mixed effects of the pandemic on college student media use and health.

Risk and resilience factors associated with college students' psychological distress and PTSD symptoms during the COVID-19 pandemic

Objective: College students are experiencing pronounced mental health difficulties as a result of the COVID-19 pandemic. Little is known, however, about underlying risk and resilience factors contributing to students' psychological health during this time. The current study examined mindfulness, resilience, coping, emotion regulation, and daily hassles as possible predictors of COVID-19 concern, psychological distress, and PTSD symptoms in a sample of college students. Participants: One hundred and thirty-five undergraduate college students participated in this study during the COVID-19 pandemic. Methods: Participants completed a series of self-report questionnaires. Results: Risk and resilience factor hierarchical regression models were run separately to predict the three outcomes. Daily hassles, ethnicity, and first-generation college student status predicted greater COVID-19 concern; daily hassles and difficulties with emotion regulation predicted greater psychological distress; daily hassles, difficulties with emotion regulation, avoidant coping, and problem-focused coping positively predicted PTSD symptoms. Acting with awareness mindfulness and continuing-generation college student status predicted lower COVID-19 concern; acting with awareness mindfulness, nonjudging mindfulness, and resilience predicted lower psychological distress; acting with awareness mindfulness, nonjudging mindfulness, and resilience also predicted lower PTSD symptomatology. Conclusions: Identifying underlying factors associated with college students' mental health during the COVID-19 pandemic may facilitate the development and implementation of targeted preventative interventions aimed at promoting well-being in this uniquely vulnerable population.

Sense of Control and Depression during Public Health Restrictions and the COVID-19 Pandemic

Depression rates have increased significantly since the onset of the COVID-19 pandemic, with a number of factors implicated in this increase, including stress, fear, social isolation and the psychological impact of public health restrictions. The main purpose of the current cross-sectional survey study was to examine the relationship between the experience of public health restrictions, the sense of control and depression, both during and after restrictions were lifted. A survey methodology was chosen, with data collected in the Republic of Ireland at two time points (January 2022 and May 2022). Time 1 participants (n = 314) were invited to repeat the measures 5 months later, with 172 agreeing to be recontacted, and 47 participants completing all measures at two time points. Findings showed that both the sense of control, in relation to perceived constraints, w = 0.43, and the experience of restrictions, w = 0.14, predicted depression at Time 1. Participants were less likely to be depressed at Time 2 and had a stronger sense of control. The Time 1 sense of control through perceived constraints predicted depression at Time 2, w = 0.45. Overall, these data show that public health restrictions and the sense of control are linked and that the sense of control has a powerful and long-lasting effect on depression status in restricted conditions, even once these have been lifted.

Families, Schools, and the Longitudinal Changes in Psychological Distress among College Students during the First Year of the COVID-19 Pandemic: Evidence from a National Panel Survey in China

BACKGROUND

The psychological well-being of students in higher education has become an increasingly important concern in the context of the COVID-19 pandemic. The majority of prior studies were cross-sectional and thereby failed to capture the individual changes in mental health over time. Moreover, few studies have explored whether and how socioeconomic and education backgrounds could be related to college students' mental health changes. This study aimed to fill these gaps.

METHODS

Data were from a nationwide, two-wave panel survey of college students in China. Baseline information was collected in November 2019, i.e., before the outbreak of the COVID-19 epidemic in China. A follow-up survey was conducted in November and December 2020, when the epidemic was effectively contained in mainland China. In both waves, mental health was assessed with the 10-item Kessler Psychological Distress Scale (K10). The between-wave changes in psychological distress were measured and categorized.

RESULTS

Overall, 13.5% of students experienced at least a one-standard-deviation increase in psychological distress over the one-year follow-up. Results from both bivariate and multivariable analysis showed that this marked distress increase was more pronounced among vocational college students (vs. academic undergraduate and postgraduate students) and those with lower levels of academic performance. In contrast, family socioeconomic status (as measured by parental education, family economic condition, and current residence) was not associated with distress changes over time.

CONCLUSIONS

These findings highlight the importance of the educational disparities within the higher education system in understanding the mental health dynamics of college students in the context of the COVID-19 pandemic.

Mental health of US undergraduate and graduate students before and during the COVID-19 pandemic: Differences across sociodemographic groups

The purposes of this study were to assess differences between sociodemographic groups in student mental health before and during the COVID-19 pandemic, to investigate whether the pandemic disproportionately affected certain groups, and to examine between-group differences in pandemic-related stressors. Data from Minnesota undergraduate and graduate students who completed an online survey in 2020 (N = 2,067) were compared to data collected from students in 2018 (N = 3,627). The survey assessed days of poor mental health, stress, stress management ability, days of adequate sleep, and pandemic-related stressors (2020 only). Multivariate analyses of variance assessed differences between study years (2020 vs. 2018), sociodemographic groups (gender, sexual orientation, race, disability, international student), and their interactions with study year in predicting mental health, and the sociodemographic groups in predicting pandemic stressors, among undergraduate and graduate students. Stress management ability decreased and sleep improved from 2018 to 2020. The sociodemographic variables most associated with poorer mental health were identifying as female, a sexual minority, or having a disability. Undergraduates reported poorer mental health than graduate students. Differences between sociodemographic groups were not larger during the pandemic, except among students with disabilities. All five sociodemographic variables were related to greater pandemic stressors in some domains.

Nutraceuticals and Physical Activity as Antidepressants: The Central Role of the Gut Microbiota

Major depressive disorder (MDD) is a common mental illness. Evidence suggests that the gut microbiota play an essential role in regulating brain functions and the pathogenesis of neuropsychiatric diseases, including MDD. There are numerous mechanisms through which the gut microbiota and brain can exchange information in a continuous, bidirectional communication. Current research emphasizes the interexchange of signals influenced by the gut microbiota that are detected and transduced in information from the gut to the nervous system involving neural, endocrine, and inflammatory mechanisms, suggesting a relationship between oxidative stress and the pathophysiology of MDD via the hyperactivation of inflammatory responses. Potential sources of inflammation in the plasma and hippocampus of depressed individuals could stem from increases in intestinal permeability. Some nutraceuticals, such as specific probiotics, namely psychobiotics, polyphenols, carotenoids, butyrate, and prebiotics, have been demonstrated to exert an antidepressant activity, but most of them need to be metabolized and activated by gut microorganisms. By inducing changes in the gut microbiota composition, physical exercise might also exert a role in alleviating depression-like symptoms. The mutual relationships among nutraceuticals, exercise, and depression will be discussed, and the potential role of the gut microbiota as a therapeutic target to treat depression will be explored.