Self-care behaviors, drinking, and smoking to cope with psychological distress during COVID-19 among Chinese college students: the role of resilience

Development of a Self-Care Autonomy in Health Scale for Late Adolescents

BACKGROUND

This paper describes the development of the Self-Care Autonomy in Health Scale for Late Adolescents (SAHSLA) for use with general samples. It addresses concerns regarding the nonclinical efficacy of self-care health scales for adolescents, particularly their ability to discriminate between lower levels of self-care.

METHODS

A survey was constructed based on literature review and subsequently evaluated in two studies. Parents (N = 57, 53 parents of girls, 4 of boys, Mage = 15.96) participated in Study 1, which investigated the internal with Cronbach's alpha and coefficient omega (ω), and convergent validity with regard to adolescent age. In Study 2, the SAHSLA scores of adolescents (N = 339, 268 girls, 73 boys, Mage = 15.87) were examined using confirmatory factor and convergent validity analyses in relation to age, gender, smoking and alcohol consumption patterns, and self-compassion assessments.

RESULTS

In Study 1, the scale total and a child's age did not substantially correlate. Both omega and alpha were moderate. Study 2 revealed a two-factor model with physical and psychological components. There were minor yet statistically significant associations found between self-judgement and psychological SAHSLA. Physical SAHSLA was not connected with age, overidentification, isolation or self-judgement, but it was statistically strongly correlated with total self-compassion.

CONCLUSIONS

The scale and study findings can be applied to health monitoring and interventions in schools and adolescent campaigns aimed at alcohol- and tobacco-use cessation.

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

BACKGROUND

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

METHODS

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

Coping Tendency as a Mediator in the Relationship Between Psychological Resilience and Health Problems Among College Students

Purpose

The study aimed to explore the status of four common health problems (ie, smoking, internet addiction, physical inactivity, psychological disorder) among college students and analyze the relationship between psychological resilience, coping tendency and health problems.

Participants and Methods

The convenience sampling method was used to recruit 500 college students from four universities. The General Information Questionnaire, Adolescent Psychological Resilience Scale, Simplified Coping Style Questionnaire and Health Risk Behavior Questionnaire were used for survey.

Results

Among the students, there were 71 smokers (15.4%) and 61 internet addicts (13.2%). Over a third of the students reported physical inactivity (35.9%) and a minority had psychological disorder (6.3%). The psychological resilience score differed between students who smoked, had internet addiction, physical inactivity, psychological disorder and those without these health-risk behaviors. Logistic regression analysis showed that negative coping tendency was the common contributing factor of physical inactivity, internet addiction and psychological disorder. Coping tendency played a partial mediating effect in the relationship between psychological resilience and health problems, with a mediating effect of 37.93%.

Conclusion

Psychological resilience can not only affect health problems directly but also influence health problems indirectly through coping tendency. Educators and administrators in universities can apply effective measures to improve psychological resilience and positive coping to prevent or reduce health problems among undergraduates.

The role of resilience in the relationship between stress and alcohol

Stress plays a well-documented role in alcohol consumption and the risk for developing alcohol use disorder. The concept of resilience - coping with and successfully adapting to stressful life experiences - has received increasing attention in the field of addiction research in recent decades, and there has been an accumulation of evidence for resilience as a protective factor against problematic alcohol consumption, risk for alcohol use disorder, disorder severity, and relapse. The conceptual and methodological approaches used in the generation of this evidence vary considerably across investigations, however. In light of this, we carried out this review in order to provide a more thorough understanding of the meaning and scope of resilience, what factors contribute to resilience, how it is measured, and how it relates to alcohol-associated phenotypes. Implications for treatment through the use of resilience-building interventions are likewise discussed, as well as implications for future research on the role of resilience in the etiology and clinical outcomes of alcohol use disorder.

Uncertainty affects cancer-related fatigue among breast cancer women undergoing peripherally inserted central catheter chemotherapy: the chain mediating role of psychological resilience and self-care

BACKGROUND

Breast cancer patients undergoing chemotherapy via peripherally inserted central catheter often experience serious behavioral and psychological challenges, with uncertainty and cancer-related fatigue being prevalent issues that profoundly impact prognosis. Therefore, this study aimed to investigate the relationship between uncertainty and cancer-related fatigue by employing a chain mediation model to examine the potential mediating roles of psychological resilience and self-care.

METHODS

A cross-sectional study was conducted with 223 breast cancer patients receiving peripherally inserted central catheter chemotherapy at two tertiary affiliated hospitals of China Medical University in Liaoning, China, from February 2021 to December 2022. Participants completed self-reported questionnaires to assess uncertainty, psychological resilience, self-care, and cancer-related fatigue. The collected data were subsequently analyzed using Pearson's correlation analysis, hierarchical regression analysis, and mediation analysis.

RESULTS

Uncertainty exhibited a significant positive correlation with cancer-related fatigue (p < 0.01) and a negative correlation with psychological resilience (p < 0.01) and self-care (p < 0.01). Uncertainty was found to impact cancer-related fatigue through three pathways: psychological resilience mediated the relationship between uncertainty and cancer-related fatigue (mediating effect = 0.240, 95% confidence interval: 0.188 to 0.298, effect ratio = 53.22%); self-care also mediated this relationship (mediating effect = 0.080, 95% confidence interval: 0.044 to 0.121, effect ratio = 17.74%); furthermore, there was a significant joint mediating effect of psychological resilience and self-care on the association between uncertainty and cancer-related fatigue (mediating effect = 0.042, 95% confidence interval: 0.021 to 0.068, effect ratio o = 9.31%).

CONCLUSION

The findings of this study revealed that uncertainty not only directly influenced cancer-related fatigue, but also operated through the mediating effect of psychological resilience, self-care, and sequential mediation of psychological resilience and self-care. Interventions tailored for breast cancer patients receiving peripherally inserted central catheter chemotherapy should target these factors to help alleviate uncertainty, enhance psychological resilience, and improve self-care practices, thereby ameliorating cancer-related fatigue.

Impact of resilience and environmental stress on burnout of students in public and private dental schools in Western Saudi Arabia

Background

Dental students' burnout has been repeatedly reported in the literature; however, there is little information about the contributing factors in different contexts and settings.

Aims

This study aimed to investigate the correlation between burnout among undergraduate dental students and sociodemographic (specifically gender), psychological (resilience), and structural factors (dental environment stress).

Subjects and Methods

An online cross-sectional survey questionnaire was distributed among a convenience sample of 500 undergraduate Saudi dental students. The survey included questions about sociodemographic factors (gender, level of education, academic achievement, type of school [public or private], and living arrangements). The study also included items that allowed assessment of students' burnout using the Maslach Burnout Inventory (MBI) and assessment of student environmental stress and resilience using the Dental Environment Stress Scale (DESS) and the Brief Resilience Scale (BRS). Descriptive statistics, univariate, and linear regression analyses were performed.

Results

The response rate was 67% (male = 119, female = 216). Univariable analysis showed that gender, level of education, and DESS and BRS scores correlated significantly (P <.05) with MBI scores. Adjusted multiple linear regression lends further support to that the MBI scores negatively correlated with the BRS score but positively correlated with the DESS score (β = -0.29, P <.001; β = 0.44, P <.001, respectively).

Conclusions

Within the limitations of this study, the findings demonstrated that increases in resilience correlated significantly with decreases in burnout and increases in environmental stress correlated significantly with increases in burnout among dental students. However, gender had no influence on burnout.

Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model

BACKGROUND

Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers.

METHODS

In January - March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors.

RESULTS

In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors ( β s = .38 to .68, p s < .001), while psychosocial factors were negatively associated with substance use behaviors ( β s = -.61 to -.43, p s < .001).

CONCLUSION

Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.

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.

Need Satisfaction and Depressive Symptoms Among University Students in Hong Kong During the COVID-19 Pandemic: Moderating Effects of Positive Youth Development Attributes

As studies on the mental health status of university students during the COVID-19 pandemic are almost non-existent in Hong Kong, we examined four research questions in this paper: What is the prevalence of depressive symptoms in university students in Hong Kong? What are the socio-demographic correlates of depressive symptoms? Do need satisfaction and positive youth development (PYD) attributes, including beliefs about adversity, psychosocial competence (resilience and emotional competence) and family functioning predict depression? Do PYD attributes moderate the predictive effect of need satisfaction on depression? We examined the above research questions using the Centre for Epidemiologic Studies Depression Scale Revised (CESD-R) in 1,648 university students in Hong Kong. For PYD attributes, we utilized validated measures of Chinese beliefs about adversity, psychosocial competence (resilience and emotional competence), and family functioning. For need satisfaction, we used a measure derived from two focus group interviews involving university students. Results showed that 48.4% of the respondents (95% confidence interval = [45.9%, 51.1%]) scored 16 or above (i.e., "at-risk" for clinical depression). As predicted, age, gender, student status (local vs. international), and family financial hardship were significant socio-demographic correlates of depressive symptoms. Besides, need satisfaction and PYD attributes negatively predicted depression scores. Finally, multiple regression analyses controlling for gender, age, and student status as covariates showed that all PYD attributes moderated the impact of need satisfaction on depression. The findings reinforce the theoretical proposition that PYD attributes serve as important factors in protecting the mental health of university students during the pandemic.