Effects of Online Social Support and Perceived Social Support on the Relationship Between Perceived Stress and Problematic Smartphone Usage Among Chinese Undergraduates

Changes in Chinese college students' mobile phone addiction over recent decade: The perspective of cross-temporal meta-analysis

In recent years, with the rapid advancement of Internet technology and the impact of the COVID-19 pandemic, mobile phones have been used more frequently, the development trend of mobile phone addiction among Chinese college students is a concern to society. This cross-temporal meta-analysis provides compelling evidence of the rising trend of mobile phone addiction in Chinese college students based on data from 42 independent studies (Sample Size = 49,544) over the past decade (2013-2022), and discuss the three important rising periods. Furthermore, extended research has revealed correlated factors of mobile phone addiction among Chinese college students, including gender, anxiety, depression, loneliness, stress, well-being, social support, and resilience. Additionally, the study identified the National internet penetration rate and the National GDP index as significant predictors of mobile phone addiction in Chinese college students. These findings not only reveal the changing trends of mobile phone addiction among Chinese college students, but also enrich the understanding of mobile phone addiction among this population and provide a reference for improving mobile phone addiction among in the future.

Feasibility of continuous smart health monitoring in pregnant population: A mixed-method approach

The utilization of smart monitoring technology offers potential for enhancing health outcomes, yet its feasibility and acceptance among Hispanic pregnant individuals remain uncertain. This is particularly crucial to investigate within the context of apparently healthy individuals identified as low risk, who still face a 10% likelihood of complications. Given their frequent underrepresentation in healthcare services and relative lack of attention, improving the feasibility of remote monitoring in this population could yield significant benefits. To address this gap, our study aimed to adapt and evaluate the practicality of a smart monitoring platform among healthy Hispanic pregnant women during the second and third trimesters of pregnancy, as well as one week following childbirth, a period when complications often arise. This longitudinal study followed n = 16 participants for an average of 17 weeks. Participants were instructed to wear the Oura ring for objective data collection, including activity, sleep, and heart rate, and to complete survey questions through REDcap to assess mental health and lifestyle factors. The study framework utilized the RE-AIM approach, with acceptability and adherence as key components of the feasibility evaluation. Our findings revealed that completion rates for biweekly and monthly surveys remained consistently high until after childbirth (approximately 80%), while daily question completion remained above 80% until 38th week of gestation, declining thereafter. The wearing rate of the Oura ring remained consistently above 80% until the 35th gestational week, decreasing to around 31% postpartum. Participants cited barriers to wearing the ring during the postpartum period, including difficulties managing the newborn, forgetfulness, and concerns about scratching the baby's skin. The enrollment rate was 71.42%, with an attrition rate of 6.25%. Thematic analysis of one-on-one interviews identified three main themes: personal desire for health improvement, social acceptability and support, and conditions influencing device/platform efficiency. In conclusion, while adherence varied based on gestational week and survey frequency, the study demonstrated strong acceptability of the smart monitoring platform among the study population, indicated by the high enrollment rate. Qualitative insights underscored the significance of personal motivation, social support, and device/platform efficiency in enhancing patient engagement with digital health monitoring during pregnancy, offering valuable considerations for future healthcare interventions in this domain.

Covid-19 psychological pressures, depression and FOMO: the mediating role of online social support and emotional regulation

BACKGROUND

The spread of the coronavirus has led to significant anxiety among university students, resulting in various mental health problems that could potentially impact their academic performance.

METHOD

To examine the mediating role of emotional regulation and online social support in the relationships between COVID-19 psychological pressures, depression, and the fear of missing out (FoMO) among young adult university students, a cross-sectional research design was employed using an online survey. The sample consisted of 521 full-time university students from China, currently enrolled in undergraduate and postgraduate programs.

RESULTS

Findings revealed that more than half (55.09%, n=287) of the university students experienced COVID-19 psychological pressures. These pressures directly contributed to increased levels of depression (β = 0.339, p < .001) and fear of missing out (β = 0.236, p < .001). Moreover, online social support and emotional regulation exhibited partial mediating effects on the association between COVID-19 psychological pressures, depression, and the fear of missing out. The results indicated that COVID-19 psychological pressures were linked to higher levels of depressive symptoms and a greater fear of missing out among university students.

CONCLUSIONS

However, the provision of timely and adequate online social support, as well as the implementation of emotional regulation strategies, mitigated the negative effects of the pandemic on students' social and emotional well-being. Consequently, this led to reduced levels of depression and fear of missing out.

Prevalence and Predictors of Psychoactive Drug Use among Chinese Men Who Have Sex with Men: A Longitudinal and Mediation Study

Few longitudinal studies have examined the prevalence of psychoactive drug use and its related predictors among Chinese men who have sex with men (MSM) in Hong Kong. This longitudinal study aimed to investigate the prevalence of psychoactive drug use in this population and the relationships of background characteristics, health status, MSM-related self-stigma, and perceived stress with psychoactive drug use. Furthermore, the study tested the mediation effect of perceived stress in the relationship between MSM-related self-stigma and psychoactive drug use based on the minority stress model and the general strain model. A total of 600 MSM were recruited through multiple sources and completed a telephone interview at baseline, and 407 completed the 6-month follow-up survey. Prevalence of using any type of psychoactive drugs in the past 12 months at baseline and in the past six months at follow-up was 16.8% and 9.1% respectively. History of sexually transmitted infection (STI), self-stigma and perceived stress significantly predicted psychoactive drug use at 6-month follow-up. Bootstrapping analysis showed that self-stigma could, directly and indirectly, predict psychoactive drug use at 6-month follow-up through perceived stress. The results highlighted the need for interventions to reduce psychoactive drug use among local MSM and its potential modifiable factors.

Perceived social support mitigates the associations among household chaos and health and well-being in rural early adolescents

PURPOSE

Previous studies have demonstrated that early adolescents residing in chaotic households experience adverse health and well-being outcomes. However, the potential protective factors that mitigate the relationship between household chaos and early adolescents' health and well-being remain unknown. Accordingly, this study aims to investigate whether perceived social support moderates the link between household chaos and the health and well-being among Chinese rural early adolescents.

METHODS

Physical health difficulties were assessed using two measures: general health and allostatic load (AL). Mental health difficulties were measured by depression. Well-being was reflected by life satisfaction. Specifically, this study included early adolescents (N = 337; Mage  = 10.88 ± 1.36 years) from rural counties in China who reported their household chaos, perceived social support, general health, depression, and life satisfaction. AL scores were determined based on six physiological indices.

RESULTS

Household chaos exhibited a negative relationship with the general health and life satisfaction while a positive correlation with depression. Moreover, perceived social support was found to moderate the association between household chaos and these health and well-being indicators of early adolescents. Specifically, early adolescents who reported higher levels of perceived social support exhibited weaker negative connections among household chaos and their general health, depression, and life satisfaction. Furthermore, no significant relationships were observed between the adolescents' AL and household chaos, perceived social support, or their interactions.

CONCLUSIONS

Household chaos poses a significant risk to health and well-being. Furthermore, the findings indicate that perceived social support can mitigate these negative effects.

Latent profile analysis of psychological needs thwarting in Chinese school teachers: longitudinal associations with problematic smartphone use, psychological distress, and perceived administrative support

Introduction

In light of the significant impact that teachers have on education quality and student growth, their mental health warrants special attention. With the increasing popularity of Information and Communication Technology (ICT) and the rise of online teaching during the pandemic, teachers have become a group prone to developing problematic smartphone use (PSU). Psychological need thwarting (PNT) has been shown to be closely related to PSU, psychological distress, and perceived administrative support. However, most previous studies have adopted a variable-centered approach, which may overlook the possibility that the three basic needs are not closely associated and could form distinct profiles. Therefore, this study aims to apply latent profile analysis to identify different PNT profiles and their associations with PSU, psychological distress, and perceived administrative support.

Methods

A longitudinal survey was conducted using convenience and purposive sampling methods. The survey involved 1,642 primary and middle school teachers working in China over a two-month interval, with the first assessment in November 2021 (Time 1) and the second in January 2022 (Time 2).

Results

The results indicate that a three-profile model, intricately based on the PNT data gathered at Time 1, is most optimal: Class 1 is labeled as 'High autonomy-High competence and Moderate relatedness thwarting', Class 2 as 'High autonomy-High competence and High relatedness thwarting', and Class 3 as 'Low psychological needs thwarting'. Distinct associations were observed among the three profiles concerning PSU, psychological distress, and perceived administrative support. Specifically, in terms of PSU, the score of Class 2 was higher than Class 1, with that of Class 3 being the lowest at Time 1, while at Time 2 no significant difference was found between any two of these three groups; in terms of distress, the scores of the three profiles were arranged from high to low as Class 2, 1, and 3 at both time points; and in terms of perceived administrative support, the order was just the opposite, with 3, 1, and 2 from high to low at both Time 1 and Time 2.

Conclusion

Notably, the consistent ranking of the three classes in terms of psychological distress and administrative support suggests a lasting influence of PNT. Future studies should explore this enduring impact further by employing additional longitudinal data sets and examining potential mediators or moderators beyond the current study's scope.

Relationship between perceived social support and mental health among Chinese college football athletes: a moderated mediation model

Previous researches have confirmed that perceived social support has a profound effect on individuals' mental health. However, the effects and potential mechanisms of perceived social support on mental health of college athletes are still largely unknown, especially during and after the COVID-19 pandemic. Thus, the aim of this study was to explore the relationship between perceived social support and mental health in college football athletes, and to evaluate whether hopelessness and psychological pressure affected this relationship. A sample of 672 Chinese college football athletes (37.9% girls; Mage = 20.43 years; SDage = 1.68) were investigated with the Perceived Social Support Scale (PSSS), the Kessler Psychological Distress Scale (K10), the Beck Hopelessness Scale (BHS) and the Perceived Stress Scale (PSS). Surveys were voluntary and anonymous. The findings revealed that, after adjusting for demographic factors, hopelessness mediated the relationship between Chinese college football athletes' perceived social support and their mental health. Furthermore, psychological pressure moderated the negative association between perceived social support and hopelessness, and the association was stronger for them with high-level psychological pressure. These results underline the need for focused strategies in the prevention and treatment of mental health issues among Chinese college football athletes.

Social Support and Daytime Sleepiness Among Chinese Medical Students: Mediating Roles of Loneliness and Problematic Smartphone Use

Background

Sleep problems have become a serious threat to public health worldwide. Daytime sleepiness is an important indicator of many sleep problems, which have a significant impact on academic performance, physical and mental health, and wellbeing among medical students. We aimed to explore the factors associated with daytime sleepiness among medical students.

Methods

We conducted a cross-sectional survey of 466 medical students recruited via convenience sampling. Self-rated psychometric scales, including the Social Support Rate Scale, the Epworth Sleepiness Scale, the Chinese version of the UCLA loneliness scale, and the Mobile Phone Addiction Index (MPAI), were utilized to evaluate social support, daytime sleepiness, loneliness, and problematic smartphone use. A sequential mediation model was constructed with daytime sleepiness as the dependent variable, social support as the independent variable, and loneliness and problematic smartphone use as mediating variables. Age, gender, and grade were taken as covariates.

Results

Social support among medical students was negatively associated with loneliness, problematic smartphone use, and daytime sleepiness (p < 0.01). A sequential mediation analysis showed that loneliness (the first mediator) and problematic smartphone use (the second mediator) sequentially mediated the path from social support to daytime sleepiness among medical students (β = -0.008; 95% CI = -0.016, -0.002). Moreover, there were also significant mediating roles observed in the relationship between social support and daytime sleepiness via loneliness only (β = -0.037; 95% CI = -0.062, -0.015) and problematic smartphone use only (β = -0.022; 95% CI = -0.041, -0.008).

Conclusion

Social support, loneliness, and problematic smartphone use among medical students influenced their daytime sleepiness. Interventions targeting medical student loneliness and problematic smartphone use behaviors might attenuate the effects from low levels of social support and further improve daytime sleepiness.

Perceived Social Support, Depressive Symptoms, Self-Compassion, and Mobile Phone Addiction: A Moderated Mediation Analysis

OBJECTIVE

The primary objective of this study is to investigate the relationships between perceived social support and mobile phone addiction, as well as the mediating effect of depressive symptoms and the moderating effect of self-compassion.

METHODS

A total of 874 college students completed questionnaires, including the perceived social support scale, depression-anxiety-stress scale, mobile phone addiction index, and the short form of the self-compassion scale. The participants included 202 males and 672 females, with an average age of 19.54 (SD = 2.16).

RESULTS

A moderated mediation analysis was conducted. The results revealed that perceived social support fully mediated the negative relationship between perceived social support and mobile phone addiction. Self-compassion attenuated the mediating effects.

CONCLUSIONS

The present study indicated that insufficient perceived social support may increase the risk of mobile phone addiction among college students because of the impact of depressive symptoms. However, self-compassion could buffer this adverse effect.

Prospective association between perceived stress and anxiety among nursing college students: the moderating roles of career adaptability and professional commitment

BACKGROUND

Anxiety may stay with nursing students throughout their internship and even persist afterwards. Although many studies have explored the effects of perceived stress on anxiety, the relationship between pre-internship perceived stress and post-internship anxiety levels has not been clarified. In addition, none had focused on the moderating roles of career adaptability and professional commitment between perceived stress and anxiety. This study aims to investigate the influence of pre-internship perceived stress on the post-internship anxiety level of nursing college students, and to analyze the moderating effects of career adaptability and professional commitment on their relationships.

METHODS

A longitudinal study design was employed. Full-time nursing college students from a Chinese medical university were recruited by convenient sampling. All surveys were conducted via Wen Juan Xing ( www.wjx.cn ), a widely used web-based survey platform in China. Two waves of surveys were collected in the pre-internship and post-internship periods, with an interval of one year. Among 823 nursing students recruited, 692 students completed all two waves of the survey (response rate: 84.08%). Participants completed a series of questionnaires examining general demographic characteristics, perceived stress, anxiety, career adaptability, and professional commitment both before and after the internship. The bias-corrected bootstrap technique of the Hayes PROCESS macro (Model 2) was used to test the moderation effect.

RESULTS

Pre-internship perceived stress was positively associated with post-internship anxiety (β = 0.474, p < 0.001). Career adaptability would mitigate the effect of perceived stress on anxiety (β = -0.009, p < 0.01, 95% CI = [-0.013, -0.004]), and this influence became stronger for nursing college students with higher levels of career adaptability. Instead, the professional commitment would enhance the effect of perceived stress on anxiety (β = 0.004, p < 0.05, 95% CI = [0.001, 0.009]).

CONCLUSIONS

Adequate career adaptability was key to alleviating anxiety among nursing interns. Nursing educators and clinical nursing managers should pay attention to cultivating the career adaptability of nursing college students in order to help them successfully achieve identity transformation and career development. Meanwhile, it is crucial to guide them to develop appropriate professional commitment.

Depressive symptoms, perceived social support, and anticipated HIV stigma among HIV-negative/unknown men who have sex with men in China during the COVID-19 pandemic: A multicenter online cross-sectional study

OBJECTIVE

To investigate the prevalence of depressive symptoms among human immunodeficiency virus (HIV)-negative/unknown men who have sex with men (MSM) in China and explore the relationship between perceived social support, anticipated HIV stigma, and depressive symptoms.

METHODS

Participants in this study were recruited from a gay social networking app (Blued) in China by convenience sampling from December 16, 2020 to March 1, 2021. Perceived Social Support Questionnaire, Anticipated HIV Stigma Questionnaire, and Center for Epidemiologic Studies Depression Scale were used to measure the social support, anticipated HIV stigma, and depressive symptoms of participants. Confirmatory factor analysis was performed to assess the reliability and validity of the measurement model. Structural equation modeling was employed to evaluate the association of perceived social support, anticipated HIV stigma, and depressive symptoms, as well as the mediation effects.

RESULTS

Overall, 47.70% (665/1394) of the participants had depressive symptoms. Perceived social support could have both direct and indirect effects on depressive symptoms with the mediating role of anticipated HIV stigma among HIV-negative/unknown MSM.

CONCLUSION

Tailored interventions regarding perceived social support and anticipated HIV stigma, such as group therapy, mutual support groups and mindfulness training, with the involvement of non-governmental or governmental organizations, should be taken into account to reduce depressive symptoms and stigma among HIV-negative/unknown MSM in China.

How Mothers’ Problematic Smartphone Use Affects Adolescents’ Problematic Smartphone Use: Mediating Roles of Time Mothers Spend with Adolescents and Adolescents’ Self-Esteem

Purpose

This study aimed to investigate the serial mediating effects of the time mothers spend with their adolescent children and the adolescents' self-esteem on the relationship between mothers' and adolescents' problematic smartphone use.

Patients and Methods

This study was a secondary analysis of data extracted from the Korean Children and Youth Panel Survey (KCYPS) in 2018, which comprised data on first-year middle school students. Mediation analysis was conducted using Model 6 of the Hayes' PROCESS macro for SPSS.

Results

The mediating effect of the time mothers spent with adolescents on the relationship between mothers' and adolescents' problematic smartphone use was significant, but the mediating effect of adolescents' self-esteem was not significant. Mothers' problematic smartphone use was found to significantly affect adolescents' problematic smartphone use by sequentially mediating the time mothers spent with adolescent children and adolescents' self-esteem.

Conclusion

It was concluded that, to lower adolescents' problematic smartphone use due to mothers' problematic smartphone use, appropriate interventions should be formulated to help adolescents develop higher self-esteem through sufficient mother-child interaction time.

Association between mobile phone addiction and social support among mainland Chinese teenagers: A meta-analysis

Background

Mobile phone addiction brings many adverse effects to teenagers, such as physical health problems, emotional problems, and academic failure, and studies have found that social support is an important influencing factor. Therefore, considering institutional, cultural and economic differences, we aimed to investigate the association between mobile phone addiction and social support among mainland Chinese teenagers, and explored the moderators affecting the relation.

Methods

Based on the PRISMA method, a meta-analysis was applied to quantitatively synthesize relevant findings to obtain reliable estimates of effect sizes and conduct moderator analyses.

Results

In total, 92 studies involving 59,716 participants and 92 effect sizes were identified by a systematic literature search. A significant low degree of negative correlation was found between mobile phone addiction and social support (r = -0.174, 95%CI = -0.213 to -0.134, p < 0.001, I ² = 96.1%). Moreover, the present meta-analysis observed significant moderating effects of participants' gender, and region on the association between social support and mobile phone addiction.

Conclusion

This study suggests that the mobile phone addiction level of teenagers could be reduced by increasing social support, and actions to improve their social support levels should be proposed based on their gender and regional differences.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021276672.

Measuring Online Social Support: Development and Validation of a Short Form for Chinese Adolescents

Supportive interactions on social media have great potential to benefit adolescents' development. However, there is no instrument to measure online social support (OSS) in China. The study aimed to develop and validate a Chinese short version of the Online Social Support Scale (OSSS). The original scale was translated into Chinese through multiple forward and backward translation protocols. The calibration sample (N = 262) was used to select items and test the reliability, validity, and internal structure of the short form. The cross-validation sample (N = 267) was then used to assess measurement invariance by multigroup confirmatory factor analysis and examine criterion validity based on its relationships with life satisfaction, depression, and time on social media. The 20-item Chinese short version of OSSS (OSSS-CS) includes four factors: esteem/emotional support, social companionship, informational support, and instrumental support. Our results suggest that the OSSS-CS has high internal consistency, construct validity, and criterion validity. Furthermore, evidence of partial cross-validity demonstrated invariance of the variance-covariance matrices, factor structure, factor loadings, and factor variance across independent samples. The results also revealed that the original OSSS could be replicated across cultures. Finally, the short form developed in the study can be used as a reliable and valid measure of online social support among the Chinese adolescent population.

Interventions in Chinese Undergraduate Students' Mental Health: Systematic Review

BACKGROUND

Over 30% of university students from 8 countries were afflicted with mental distress according to a World Health Organization survey. Undergraduate students in increasing numbers in China have also been reported to suffer from different mental problems. Various psychological distresses significantly impact their academic and daily life, thereby causing role impairments and unsatisfactory academic achievements. While the prevalence of, diverse underlying factors for, and interventions of social support in college students' mental health have extensively been investigated in China, there is no study exclusively focusing on the impact of interventions on their psychological well-being.

OBJECTIVE

The aim of this review was to identify and synthesize the interventions in the mental health concerns of Chinese undergraduate students studying in China reported in the literature to inform educational authorities, college and university management, students' affairs counselors, and mental health providers.

METHODS

We performed a systematic review and reported the research findings of previous studies according to the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. First, based on the predefined search strategy, keyword searches were performed in the PubMed and ProQuest databases to retrieve relevant studies. Subsequently, we screened the candidate articles based on predefined inclusion and exclusion criteria. Finally, we analyzed the included papers for qualitative synthesis.

RESULTS

We retrieved a total of 675 studies from the PubMed and ProQuest databases using the search strategy on March 15, 2022. Among these candidate studies, 15 that were not written in English, 76 duplicates, and 149 studies of other document types were removed before screening. An additional 313 studies were excluded in the screening process, with 73 articles ruled out for being not relevant to interventions, not related to mental health, or not focused on undergraduate students in the full-text review. As a result, 49 papers were eligible and included in this systematic review. In the qualitative synthesis, we divided the interventions reported in the selected studies into two categories: (1) social support from government authorities, university authorities, students' affairs counselors and teachers, family members, health care authorities and professionals, and the media (various online platforms), and (2) various coping strategies adopted by undergraduate students themselves. We identified further research on mental health interventions that may be delivered by digital medical platforms, conversational agents (eg, chatbots), and researchers.

CONCLUSIONS

This was the first systematic review of interventions to address the mental health concerns of Chinese undergraduate students studying in China. The categorization of reported interventions and the identification of new intervention channels can effectively inform stakeholders. Interventions for undergraduate students' mental health is a research topic worth further investigation.

A Double-Edged Impact of Social Smartphone Use on Smartphone Addiction: A Parallel Mediation Model

Evidence supports predictive roles of non-social smartphone use for smartphone addiction, but the relationship of social smartphone use and smartphone addiction is unclear. This study explored whether social smartphone use has a double-edged impact on smartphone addiction. Using data from a sample of 909 Chinese undergraduates, we tested a parallel mediation model that considered online social support and realistic social support as mediators. As predicted, social smartphone use weakened smartphone addiction through realistic social support and contributed to smartphone addiction through online social support. Moreover, we tested the moderating role of agreeableness in the mediation path of online social support. Agreeableness only moderated the indirect effects. Specifically, the predictive effects of online social support on smartphone addiction was greater for lower rather than higher agreeableness. The results suggest that social needs play an important role in the formation of smartphone addiction. Several limitations and implications are also discussed herein.

Longitudinal Effects of Stressful Life Events on Problematic Smartphone Use and the Mediating Roles of Mental Health Problems in Chinese Undergraduate Students

Background and Aims: This three-wave longitudinal study investigated the effects of stressful life events on problematic smartphone use and the mediating roles of mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) in Chinese undergraduate students. Methods: A total of 197 undergraduate students completed the three-wave surveys. Their severity of stressful life events, mental health problems, and problematic smartphone use were assessed. Results: Regression analyses revealed that stressful life events at T1 was significantly associated with problematic smartphone use at T3. Mediation analyses showed that mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) at T2 fully mediated the association between stressful life events at T1 and problematic smartphone use at T3 (B = 0.042, 0.034, and 0.022, respectively). Conclusions: The present study revealed that stressful life events and mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) are predictors of problematic smartphone use in Chinese college students.