COVID-19-Related Variables and Its Association with Anxiety and Suicidal Ideation: Differences Between International and Local University Students in Taiwan

Psychometric properties of anxiety sensitivity Index-3 among Chinese college students and its preliminary application among this population experiencing campus lockdown

PURPOSE

Anxiety sensitivity (AS) refers to fear of anxiety-related sensory arousal and has been revealed to be associated with increased psychological distress and mental problems. Although Anxiety Sensitivity Index-3 (ASI-3) has been confirmed to be effective in evaluating this construct, whether it is consistently applicable in college students is still elusive. The present study aimed to examine the psychometric properties and measurement invariance of Chinese version of ASI-3 (C-ASI-3) among college students experiencing campus lockdown due to novel coronavirus disease 2019 (COVID-19) pandemic.

METHODS

A total of 1532 Chinese college students (397, 25.9% males) aged between 16 and 25 were included in this study. Confirmatory factor analysis (CFA) was used to verify the factor structure of C-ASI-3. Multi-group CFA was conducted for analysis of measurement invariance with regard to gender. McDonald's omega values were computed for examination of scale reliability. For criterion, convergent, and divergent validity, average variance extracted (AVE) values for C-ASI-3 subscales, difference between square root of AVE for each factor and inter-factor correlation, as well as pearson correlation and partial correlation between the C-ASI-3 and other three scales, including the Depression, Anxiety, and Stress Scale-21 (DASS-21), the State-Trait Anxiety Inventory (STAI), and the Fear of COVID-19 scale (FCV-19 S) were evaluated.

RESULTS

The C-ASI-3 presented a three-factor scale structure with fit indices being as follows: χ2/df = 11.590, CFI = 0.938, RMSEA = 0.083, SRMR = 0.042. Strict measurement invariance was reached across gender. Regarding convergent validity, the C-ASI-3 had a high correlation with the DASS-21 (r = 0.597, p < 0.01) and the STAI (r = 0.504, p < 0.01). All AVE values for C-ASI-3 subscales were above 0.5. In terms of divergent validity, the C-ASI-3 had medium correlation with the FCV-19 S (r = 0.360, p < 0.01). Square of root of AVE for each factor was higher that inter-factor correlation. McDonald's omega values of the three dimensions ranged from 0.898 ~ 0.958.

CONCLUSION

The C-ASI-3 has acceptable psychometric properties among college students. College students with different gender have consistent understanding on the scale construct.

Understanding the mental health impacts of biological disasters: Lessons from Taiwan's experience with COVID-19

Biological disasters pose a growing challenge in the 21st century, significantly impacting global society. Taiwan has experienced such disasters, resulting in long-term consequences like loss of life, trauma, economic decline, and societal disruptions. Post-disaster, mental health issues such as fear, anxiety, depression, post-traumatic stress disorder (PTSD), and stress surge, accompanied by increased suicide rates. The Coronavirus disease 2019 (COVID-19) (also called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) pandemic, recognized as a biological disaster, triggered lockdowns and quarantines in Taiwan, causing lifestyle changes, economic recession, and so on. These shifts may elevate uncertainty about the future, intensifying mental stress and leading to a rise in various mental illnesses. This article reviews mental health studies conducted in Taiwan during the pandemic, emphasizing the need to integrate this research for future preparedness and interventions regarding the mental health impacts of biological disasters, including COVID-19. Further research is essential to explore long-term effects, interventions, and generalizability.

Quality of life among residents of Gaza, Palestine: the predictive role of mental distress, fear of COVID-19, and social support

BACKGROUND

Living under siege and deteriorated health, social, educational, and economic conditions and isolation with scarce opportunities to fulfil basic needs and aspirations affect the civil population's mental health and perceived quality of life. In this cross-sectional investigation, we explored the consequences of mental distress, fear of COVID-19, and social support for QoL in the Gaza strip.

METHODS

Nine hundred seventy nine (32.9% males; 67.1% females; mean age was 35.2 years; s.d. = 11.4) adults were recruited in the Gaza strip. We used the Fear for COVID-19 scale (FCS-19), The WHOQOL-BREF Scale, Berlin Social Support Scale (BSSS), Depression Anxiety and Stress Scale (DASS). Pearson correlation coefficient was computed to assess relationships between quality of life, fear of COVID19, mental distress, and social support; a hierarchical regression analysis was used to assess the association between QoL as the dependent variable and demographic variables and fear of COVID19, mental health, and social support as the independent variables.

RESULTS

QoL was positively associated with perceived emotion, instrumental, and support seeking. Depression, anxiety, stress, and fear of COVID19 were negatively associated with quality of life. Gender was significantly associated with lower QoL. The study highlighted that the level of fear of COVID-19 was negatively influencing individuals' quality of life (QoL). This fear was negatively associated to psychological distress, gender, place of residence, and family type. Lower-educated and poorer participants had lower QoL scores. Conversely, female gender was notably linked to a lower QOL. The hierarchical regression confirmed that COVID-19 was an added burden for the Palestinian population. The fear of COVID-19 term added a 6.2% variance in QoL. In the final analysis, all predictors were statistically significant, with the fear of COVID-19 term recording a higher contribution of 22.5%, followed by depression term with 21.5%, perceived emotional 18.5%, income at 15.4%, and perceived instruments at 14.8% towards QoL.

CONCLUSIONS

Practitioners and policymakers must consider the severe violation of human rights when developing psychosocial programs to intervene in the COVID-19 crisis.

Psychosocial and financial well-being mediated the effects of COVID-19 distress on suicidality: a serial mediation model among Hong Kong young adults

PURPOSE

The COVID-19 pandemic has brought significant distress on not only the physical health but also mental health of individuals. The present study investigated the direct and indirect effects from COVID-19 distress to suicidality via psychosocial and financial well-being among young people.

METHODS

This cross-sectional survey recruited 1472 Hong Kong young people via random sampling in 2021. The respondents completed a phone survey on COVID-19 distress, the four-item Patient Health Questionnaire and items on social well-being, financial well-being, and suicidality. Structural equation modeling (SEM) was conducted to examine the direct and indirect effects of COVID-19 distress on suicidality via psychosocial and financial well-being.

RESULTS

The direct effect of COVID-19 distress on suicidality was not significant (β = 0.022, 95% CI  - 0.097-0.156). The total indirect effect from COVID-19 distress to suicidality was significant and positive (αβγ = 0.150, 95% CI = 0.085-0.245) and accounted for 87% of the total effect (B = 0.172, 95% CI = 0.043-0.341). There were significant specific indirect effects via social well-being and psychological distress, and financial well-being and psychological distress.

CONCLUSION

The present findings support different pathways from COVID-19 distress to suicidality via functioning in different domains among young people in Hong Kong. Measures are needed to ameliorate the impact on their social and financial well-being to reduce their psychological distress and suicidality.

Socio-demographic and mental health correlates of internet addiction amongst Hong Kong university students under COVID-19

Introduction

Regarding the problem of Internet addiction (IA) amongst university students under the pandemic, there are several research gaps. Firstly, few studies have examined IA of university students in Hong Kong, which is a Chinese society heavily influenced by Western values. In addition, findings on the socio-demographic correlates and psychological well-being predictors of IA in university students are unclear. Finally, researchers have not systematically examined the interaction effects of socio-demographic factors (particularly gender and personal infection of COVID-19) and psychological morbidity on IA. This pioneer study aimed to investigate the predictive role of socio-demographic factors and psychological morbidity in IA, and the moderating effects of gender and personal infection of COVID-19 on the relationship between psychological morbidity and IA.

Methods

We conducted an online survey (N = 1,020 university students) during the ending phase of Wave 5 of the pandemic in Hong Kong (late 2022 to early 2023). Socio-demographic correlates included age, gender, living status, personal and family financial situation, student status, personal and family infection of COVID-19. Participants responded to validated measures of psychological morbidity, including depression, suicidal behavior, and hopelessness. Hierarchical regression and simple slope analyses were used to examine the predictive role of socio-demographic variables and psychological morbidity in IA and the interactive effect of gender and personal infection of COVID-19 with psychological morbidity on IA.

Results

Personal financial difficulty was a significant socio-demographic predictor of IA. Depression, suicidal behavior, and hopelessness positively predicted IA. We also found a significant interaction effect of gender and psychological morbidity on IA. While the predictive relationship between depression and IA was stronger in males than in females, hopelessness was more strongly related to IA in females than in males. Finally, there was a significant interaction effect of personal infection of COVID-19 and suicidal behavior on IA.

Conclusion

Personal financial difficulty was a socio-economic correlate of IA. Psychological morbidity also predicted IA. Gender and personal infection of COVID-19 moderated the linkage between psychological morbidity and IA. The findings of the study enhance our understanding of individual differences in IA in university students during the pandemic, particularly concerning different ecological risk factors.

Challenges Posed by COVID-19 on Doctoral Students' Wellbeing in Russia: Of International and Domestic Doctoral Students, Who Suffers More?

Background

While universities closed, implementing remote teaching and learning in response to COVID-19, this change significantly impacted the lives of graduate students, given their exposure to unique and diverse experiences. It thus has become essential to understand the possible differences in regard to the pandemic's impact on international and domestic students.

Purpose

The aim of this study was to explore the consequences of the challenges posed by COVID-19 on doctoral students' wellbeing in Russia.

Methods

The study surveyed 4454 doctoral students across 249 Russian public universities.

Results

The challenges posed by COVID-19 negatively affected international doctoral students' learning experience (β= -0.269, p<0.001); students' satisfaction with supervision (β= -0.098, p<0.001); dissertation experience (β= -0.039, p<0.001); and doctoral program satisfaction (β= -0.034, p<0.001). Furthermore, the challenges posed by COVID-19 affected domestic doctoral students' learning experience (β=-0.368, p<0.001); students' satisfaction with supervision (β=-0.194, p<0.001) and doctoral program satisfaction (β=-0.034, p<0.001). However, the influence of the challenges posed by COVID-19 on communication frequency was relatively positive for both international (β=0.060, p<0.001) and domestic students (β=0.021, p<0.001), and dissertation experience (β=0.061, p<0.001) was also positive for only domestic students. Furthermore, controlled factors comprising field of study (β=-0.033, p<0.001); year of study (β=0.127, p<0.001); and university region (β=-0.056, p<0.001) influenced the effect of the challenges posed by COVID-19 on international doctoral students.

Conclusion

The COVID-19 challenges had the greatest impact on the wellbeing of international students. Furthermore, both international and domestic students' communication frequency with their supervisors underwent a relatively positive impact (which implies no effect on both categories of students). Furthermore, the challenges posed by COVID-19 had no effect on domestic students' dissertation experiences. Finally, among the controlled variables, field of study, year of study, and university region were discovered to be significant factors in relation to the challenges posed by COVID-19 for international students.

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.

From Academic Resilience to Academic Burnout among International University Students during the Post-COVID-19 New Normal: An Empirical Study in Taiwan

(1) Background: In the context of the COVID-19 pandemic, it is imperative for higher education institutions to understand the socio-psychological issues of international students, a potentially vulnerable population on campuses, to assist them in pursuing their academic path while maintaining their psychological well-being. The objectives of this study were to determine the prevalence of academic burnout among international university students in Taiwan during the new normal and to explore the protective role of academic resilience. (2) Methods: Three hundred and eighty-three international university students in Taiwan were recruited and surveyed via the online self-administered questionnaire during the Fall semester of the 2022–2023 academic year. The data of sociodemographic characteristics, academic burnout, and academic resilience were collected and analyzed. (3) Results: The overall prevalence of high academic burnout was 12.01%. The majority of participants perceived significant depression and anxiety (detrimental factors) but moderate to high perception of academics and relationships (protective factors). There were significant relationships between resilience components and burnout symptoms. (4) Conclusions: Resilience may help to reduce burnout among international university students during the post-COVID-19 new normal, thereby protecting their mental health.

Factors Associated with Psychosocial Symptoms Experienced by Students in Response to COVID-19 Pandemic: A Multivariate Analysis

The COVID-19 pandemic has significantly impacted many sectors, including the education sector. After in-person school activities were suspended due to the pandemic, a number of educational institutions in Indonesia reported concerns in implementing online learning due to the institutions' unpreparedness. This issue may potentially induce mental health disorders among students and triggers long-term stress. This study aimed to examine factors linked to the psychosocial symptoms of anxiety, stress, and depression in response to the early stage of the COVID-19 pandemic. An online cross-sectional study in Indonesia was conducted with 433 undergraduate and senior high school students aged 15 to 26 years old, both female and male. The self-reported symptoms were analyzed using both bivariate and multivariate linear regression methods. It was found that the percentage of participants with depression symptoms was 66%, while 61% and 43% participants experienced stress and anxiety respectively. The bivariate analysis presented strong correlations between anxiety and gender, learning duration and use of gadgets, internet expenses, and highly-interrupted learning. Furthermore, the multivariate regression revealed that only anxiety was significantly linked to internet expenses. This study indicates that many students are affected by COVID-19, the impacts of which manifest in psychosocial issues in the form of anxiety. We suggest that creating a supportive and positive family environment would help to alleviate some of these issues.

The Effect of COVID-19 Vaccine Acceptance, Intention, and/or Hesitancy and Its Association with Our Health and/or Important Areas of Functioning

The emergence of coronavirus 2019 (COVID-19) has had a significant negative impact on the world, with its effect noted in various areas, such as commerce [...].

Depression, anxiety, and stress among university students in Selangor, Malaysia during COVID-19 pandemics and their associated factors

INTRODUCTION

This study aims to assess the impacts of COVID-19 pandemics among university students in Malaysia, by identifying the prevalence of depression, anxiety and stress among them and their respective predictors.

METHODOLOGY

An online cross-sectional study was conducted via non-probabilistic convenience sampling. Data were collected on sociodemographic characteristics, lifestyle, COVID-19 related influences. Mental health status was assessed with depression, anxiety, and stress scale (DASS-21).

RESULTS

388 students participated this study (72.4% female; 81.7% Bachelor's student). The prevalence of moderate to severe depression, anxiety and stress among university students are 53.9%, 66.2% and 44.6%, respectively. Multivariable logistic regression analysis found that the odds of depression were lower among students who exercise at least 3 times per week (OR: 0.380, 95% CI: 0.203-0.711). The odd ratio of student who had no personal history of depression to had depression, anxiety and stress during this pandemic was also lower in comparison (OR: 0.489, 95% CI: 0.249-0.962; OR: 0.482, 95% CI: 0.241-0.963; OR: 0.252, 95% CI: 0.111-0.576). Surprisingly, students whose are currently pursuing Master study was associated with lower stress levels (OR: 0.188, 95% CI: 0.053-0.663). However, student who had poorer satisfaction of current learning experience were more likely to experience stress (OR: 1.644, 95% CI: 1.010-2.675).

LIMITATIONS

It is impossible to establish causal relationships between variables on mental health outcomes, and there is a risk of information bias.

CONCLUSION

The prevalence of mental health issues among university students is high. These findings present essential pieces of predictive information when promoting related awareness among them.

Correlates of stress are interactive and not unidimensional: Evidence from U.S. college students early in the COVID-19 pandemic

Studies have investigated various aspects of how the COVID-19 pandemic has impacted college students' well-being. However, the complex relationships between stress and its correlates have received limited attention. Thus, the main objective of this study is to evaluate multiplicative associations between stress and demographic, lifestyle, and other negative emotion factors during the pandemic. We used data from a survey with 2,534 students enrolled in seven U.S. universities and analyzed such data with generalized additive Tobit models and pairwise interaction terms. The results highlighted associations and interactions between myriad factors such as students' social class, income, parental education, body mass index (BMI), amount of exercise, and knowing infected people in the student's communities. For instance, we found that the associations between feeling irritable and sad due to the pandemic were interactive, resulting in higher associated stress for students with higher levels of parents' education. Furthermore, associations between taking precautionary actions (i.e., avoiding travel and large gatherings) and stress varied with the intensity of negative feelings (i.e., sadness and irritability). Considering these interaction terms, the results highlighted a great inequality in pandemic-related stress within low income, lower social class, and higher BMI students. This study is among the earliest that employed a stratified approach with numerous interaction terms to better understand the multiplicative associations between different factors during the COVID-19 pandemic.

The Mediating Role of Selfitis in the Associations between Self-Esteem, Problematic Social Media Use, Problematic Smartphone Use, Body-Self Appearance, and Psychological Distress among Young Ghanaian Adults

Selfie-related activities have become pervasive to the point that they may affect the mental health of people who engage in them. To ascertain this mechanism, this study examined the mediating role of selfitis in the associations between self-esteem, problematic social media use, problematic smartphone use, body-self appearance, and psychological distress among young Ghanaian adults. A total of 651 participants completed a questionnaire with measures on self-esteem, body-self appearance, problematic social media use, problematic smartphone use, depression, anxiety, stress, coping skills, and selfitis. There were direct associations between all the variables except between self-esteem and selfitis. In addition, selfitis mediated the associations between problematic social media use, problematic smartphone use, body-self appearance, and psychological distress except between self-esteem and psychological distress. These findings suggest that selfitis can serve as a pathway by which people who overly engage in problematic social media use, problematic smartphone use, and have poor body-self appearance may experience psychological distress. Hence, there is a need for health communicators, school authorities, and opinion leaders to educate young adults on the consequences of the problematic use of technology, especially for selfitis behaviour. Future studies can examine the factors that predict selfitis behaviour among adults.

The social and mental impact on healthcare workers: A comparative and cross-sectional study during two waves of the COVID-19 pandemic in Taiwan

The coronavirus disease 2019 (COVID-19) pandemic has caused a heavily burden on healthcare workers (HCWs) worldwide. The aim of this study was to compare differences in psychological and social impact between two waves of the pandemic among first- and second-line HCWs in Taiwan. The current study derived data from two cross-sectional surveys conducted in 2020 and 2021. Levels of depression, sleep disturbance, psychological distress, social impact, and demographic variables were collected through self-reported questionnaires. The independent t test was used to compare differences in scores between the first and second wave of the pandemic. Differences between first- and second-line HCWs were also analyzed. A total of 711 HCWs in the first wave and 560 HCWs in the second wave were recruited. For the first- and second-line HCWs, the social impact during the second wave was higher than during the first wave, and they expressed a higher intention to maintain social distancing and were more aware of the pandemic overseas in the second wave. The first-line HCWs had a trend of worse sleep quality during the second wave. In addition, sleep quality was worse in the first-line HCWs than in the second-line HCWs during both waves. The second-line HCWs expressed a greater desire to seek COVID-19-related information than the first-line HCWs during the first wave, and more intended to maintain social distancing during the second wave. Our results show the importance of evaluating the social and mental health burden of HCWs, and especially first-line workers.

Association between lifestyle choices and mental health among medical students during the COVID-19 pandemic: A cross-sectional study

INTRODUCTION

Mental health is recognized as a critical component of public health Given the close relationship between mental health and life style and the importance of students as valuable human resources, the present study aimed at determining the relationship between life style and mental health among medical students in Sousse during COVID-19 pandemic.

METHODS

We conducted a cross-sectional observational study in university students from the first to the fifth grade of the Faculty of Medicine of Sousse during the academic year 2020/2021. Data were collected anonymously via an online questionnaire published on the Facebook groups of each grade, on december 2020. The online survey consisted of three sections. The first one aimed to collect sociodemographic information. The second section of the survey addressed recent lifestyle choices and the third one assessed psychological distress using the French version of 12 items of The General Health Questionnaire (GHQ-12). The significance level was considered 0.05.

RESULTS

Overall 147 were studied. Using the bimodal scoring, the total score was between 0 and 12, to evoke psychiatric disorders, we set the threshold of 4. For our sample, the median scale was 7 [4-9], and more than half of the students (68%; n = 100) had a score higher than 4. Psychiatric disorder was significantly more frequent in female students (73.3% vs 42.3%; p = 0.002). Higher GHQ-scale was found in younger students, foreigners, students who need more than 30 minutes to get to the faculty, unemployed students, and students of fifth grade. However, differences were not statistically significant. Regarding lifestyle choices, we found that physical inactivity, no smoking habits, no alcohol use, no illicit substance use, other substance use, changing in eating habits, and absence of coping methods of stress were higher in students with psychiatric disorders. However, this association was statistically significant only for physical activity (p = 0.016). The results of the regression analysis suggest female gender as an independent predictor of high GHQ-12 scores. Practicing physical activity was found as protective factor for psychiatric disorders.

CONCLUSION

Considering the vital role of medical students in providing and promoting community health, the need for more detailed planning and interventions to improve their life style and mental health is essential.

The Mediating Roles of Anxiety, Depression, Sleepiness, Insomnia, and Sleep Quality in the Association between Problematic Social Media Use and Quality of Life among Patients with Cancer

The present study examined the mediating role of anxiety, depression, sleepiness, insomnia, and sleep quality in the association between problematic social media use and quality of life (QoL) among patients with cancer. This cross-sectional survey study recruited 288 patients with cancer to respond to measures on anxiety, depression, sleepiness, insomnia, sleep quality, problematic social media use, and QoL. Structural Equation Modeling was used for the mediation analysis. There were significant relationships between all of the variables used in the study. It was revealed that problematic social media use did not directly influence the QoL of patients with cancer except via anxiety, depression, sleepiness, and insomnia. Sleep quality did not mediate the association between problematic social media use and QoL. Healthcare workers managing cancer should pay attention to the mental health needs of their patients even as they treat their cancer so as to improve their quality of life. Future studies may examine other variables that affect the QoL of patients with cancer as well as other mediating and moderating variables.

University Students' Risk Perception, Protective Measures, and General Health During the COVID-19 Pandemic in Turkey

OBJECTIVE

This study aimed to investigate university students' risk perception, protective measures, and general health during the coronavirus disease 2019 (COVID-19) pandemic in Turkey.

METHODS

The research sample consisted of 1920 university students. The data were collected through an online questionnaire.

RESULTS

A total of 56.6% of the students considered their risk of being infected with the COVID-19. The number of measures taken by students was lower than expected. Students' increased anxiety perceived individual risk level, insufficient social support perceptions, and their perceptions of the current pandemic more serious than previous epidemics affect the number of measures they take. Students had sleep and study problems, and suicidal thoughts in the social isolation period. Sex, studying in medicine, anxiety related to COVID-19, feeling unconfident in coping with the pandemic, social support, were determined to be risk factors regarding general health, sleep and study problems, and suicidal thoughts.

CONCLUSIONS

The results of the study showed that the measures taken by university students were insufficient and the precautions were affected by many factors. It was determined that their health was adversely affected by the pandemic. University administrations and decision-makers should consider the risk factors to improve the students' experiences in such pandemics and emergencies.

The relationship between spiritual health and happiness in medical students during the COVID-19 outbreak: A survey in southeastern Iran

It is necessary to study the various dimensions of health and their affecting factors during the coronavirus disease-19 (COVID-19) pandemic to identify the necessary interventions. The study aims to determine the relationship between spiritual health and happiness in medical students during the COVID-19 outbreak. In this analytical cross-sectional design study, 409 medical students were examined for the state of happiness and spiritual health and the relationship between them. Student information was collected through Web-based sampling by using standard tools from 20 April to 20 June 2020. Medical students completed the demographic questionnaire as well as Oxford Happiness Questionnaire (OHQ) and Paloutzian and Ellison spiritual health questionnaire. The results showed that while the score of spiritual health and happiness was related to factors such as marriage, interest in a field of study, and socioeconomic status, the relationship between spiritual health and happiness was significant (r = 0.72). This study showed that students' happiness scores were not optimal during the COVID-19 pandemic. Due to the strong relationship between spiritual health and happiness scores, spiritual health promotion, in conjunction with other interventions, can be used to improve happiness in this group.

Negative perfectionism and sleep quality in Chinese international students under COVID-19 epidemic: A moderated mediation

Objective

This study used a moderated mediation model to test the mediating effect of anxiety on the relationship between negative perfectionism and sleep quality and the moderating effect of COVID-19 epidemic risk perception during the COVID-19 pandemic in Chinese international students.

Materials and methods

A sample of 239 Chinese international students from the south of China, was surveyed with the Negative and Positive Perfectionism Scale, the Pittsburgh Sleep Quality Index, the General Anxiety Disorder Scale, and the COVID-19 Epidemic Risk Perception Inventory. Version 23.0 of SPSS and version 3.4 of PROCESS were used to perform the correlation analyses, mediation analysis, and moderated mediation analysis.

Results

(1) Negative perfectionism was significantly correlated with anxiety (r = 0.371, p < 0.01) and poor sleep quality (r = 0.291, p < 0.01). Anxiety was significantly correlated with poor sleep quality (r = 0.594, p < 0.01). (2) The mediating effect test showed that anxiety had a mediating effect between negative perfectionism and poor sleep quality (β = 0.157, p < 0.01). (3) Epidemic risk perception moderated the mediating effect of anxiety between negative perfectionism and poor sleep quality (β = 0.070, p < 0.01).

Conclusion

Negative perfectionism affected sleep quality indirectly through anxiety. In particular, COVID-19 epidemic risk perception moderated the relationship between anxiety and sleep quality, such that the association was stronger when the COVID-19 epidemic risk perception was high. These results provide a more comprehensive understanding of the negative link between negative perfectionism and poor sleep quality.

Fear of COVID-19 infection and related factors in Japan: A comparison of college students, pregnant women, hospital nurses and the general public

The fear of COVID-19 has become a social problem during the pandemic. The present study compares the fear of COVID-19 among members of the general public, college students, pregnant women, and hospital nurses. It also examines various factors associated with the fear of COVID-19. In this study, we conducted a survey of the general public on fear of infection and related factors and compared from previous studies of college students, pregnant women, and hospital nurses. A crowdsourced survey was administered to 450 members of the general public, who were asked about their fear of COVID-19 infection. Data from college students, nurses, and pregnant women were recruited from a May-June 2020 survey on fear of COVID-19. An analysis of variance was used to compare the fear of infection among different attribution. The results showed that more pregnant women and fewer college students feared infection, as did equal numbers of hospital nurses and members of the general public. The multiple regression analysis revealed that college students and pregnant women associated the fear of infection with their key source of information, while hospital nurses associated the fear of infection with living with an older person. These results suggest that pregnant women have a significant fear of infection, which is further defined by the risk of serious illness in cases of infection. Although the fear of infection is relatively low among hospital nurses, they fear becoming a source of infection. These results reveal the groups in Japan that fear infection and the reasons for their concern. The present study may help to provide psychological support to counteract the fear of infection in vulnerable groups.

A Network Analysis of the Fear of COVID-19 Scale (FCV-19S): A Large-Scale Cross-Cultural Study in Iran, Bangladesh, and Norway

The rapid spread of the coronavirus disease 2019 (COVID-19) has led to high levels of fear worldwide. Given that fear is an important factor in causing psychological distress and facilitating preventive behaviors, assessing the fear of COVID-19 is important. The seven-item Fear of COVID-19 Scale (FCV-19S) is a widely used psychometric instrument to assess this fear. However, the factor structure of the FCV-19S remains unclear according to the current evidence. Therefore, the present study used a network analysis to provide further empirical evidence for the factor structure of FCV-19S. A total of 24,429 participants from Iran (n = 10,843), Bangladesh (n = 9906), and Norway (n = 3680) completed the FCV-19S in their local language. A network analysis (via regularized partial correlation networks) was applied to investigate the seven FCV-19S items. Moreover, relationships between the FCV-19S items were compared across gender (males vs. females), age groups (18−30 years, 31−50 years, and >50 years), and countries (Iran, Bangladesh, and Norway). A two-factor structure pattern was observed (three items concerning physical factors, including clammy hands, insomnia, and heart palpitations; four items concerning psychosocial factors, including being afraid, uncomfortable, afraid of dying, and anxious about COVID-19 news). Moreover, this pattern was found to be the same among men and women, across age groups and countries. The network analysis used in the present study verified the two-factor structure for the FCV-19S. Future studies may consider using the two-factor structure of FCV-19S to assess the fear of COVID-19 during the COVID-19 era.

Mental Health and Related Factors Among Undergraduate Students During SARS-CoV-2 Pandemic: A Cross-Sectional Study

Background

Mental health problems among undergraduates are a significant public health concern. Most studies exploring mental health in this population during the pandemic have been conducted in high-income countries. Fewer studies come from Latin American countries. The aim of this study was to determine the prevalence of depression, anxiety, stress, insomnia, and suicide risk, and explore the association with several relevant variables in personal, family, university, and SARS-CoV-2 pandemic domains.

Methods

A cross-sectional study was conducted in Chile in a medium-size private University. Outcome variables were explored with valid instruments: Depression, Anxiety, and Stress Scale (DASS-21), Insomnia Severity Index (ISI), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Independent variables from personal (e.g., sex, age, sexual orientation, history of mental health problems, substance use), family (e.g., parental educational background, family history of mental health problems, family functioning), university (e.g., course year, financial support, psychological sense of university belonging, history of failing subjects) and SARS-CoV-2 domains (e.g., history of personal and family contagion, fear of contracting SARS-CoV-2, frequency of physical activity, keeping routines and social contact). Multivariable logistic regression models were conducted for each outcome, after univariable and domain-specific multivariable models. The significant variable at each step was selected if the p-value was ≤ 0.05.

Results

A total of 5,037 students answered the survey-the global response rate of 63.5%. Most of the students were females (70.4%) and freshmen students (25.2%). The prevalence of mental health problems was high: depression (37.1%), anxiety (37.9%), and stress (54.6%). Insomnia was reported in 32.5% of students, and suicide risk in 20.4% of students. The associated variables at personal domain were history of mental health problems, substance use, and sexual orientation; at family domain, family functioning and family history of mental health problems; at university domain, violence victimization and sense of belonging; and in SARS-CoV-2 domain, having a daily routine and fear to contracting SARS-CoV-2 by students themselves or others.

Conclusions

The prevalence of mental health problems is high among undergraduate students and some of the associated factors, such as victimization and a sense of belonging can be used in preventive interventions.

Psychological Distress, Anxiety, Family Violence, Suicidality, and Wellbeing in Pakistan During the COVID-19 Lockdown: A Cross-Sectional Study

Background and Objectives

The purpose of this study was to draw the attention toward the implications of COVID-19 and the related restrictions imposed worldwide especially in Pakistan. The primary objective was to highlight the levels of psychological distress, anxiety, family violence, suicidality, and well-being due to COVID-19 and the secondary objective was to associate it to social demographic factors.

Materials and Methods

It is designed as a cross-sectional study by employing an online questionnaire in the English language and obtaining responses using a snowball sampling technique. We used three validated measures including Kessler Psychological Distress Scale (K10), Generalized Anxiety Disorder (GAD-7) index and World Health Organization Well-Being Index (WHO-5).

Results

A sample of 420 participants was recruited from across Pakistan, with most participants were females (79%), students (89.8%) and belonging to Punjab (54%). Nearly one-fourth of the participants (23.8%) scored above the minimum value set for moderate or high psychological distress (K10 > 12). There was a higher prevalence of distress among females and resident of province Punjab. The majority of individuals reported that they were living with their family (94.5%) and more than half (52.6%) were neutral regarding their satisfaction with their living conditions. 40.5% believed that the lockdown has had a negative impact on their mental health. 31.4% have reported that they themselves have experienced abuse from a family member. 48.6% scored high on the GAD-7 scale and low wellbeing score was found among 80.2%. Students were found to be more vulnerable to mental illness and anxiety.

Conclusion

With the lockdown restrictions, psychosocial distress has become prevalent in Pakistan.

Fear of COVID-19 Among College Students: A Systematic Review and Meta-Analysis

Background

Mental health issue among college students is routinely a major public health concern, and coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the students' mental health issues which include psychological distress, panic disorder, insomnia, and posttraumatic stress symptoms. However, few studies reached a consensus on the impact of COVID-19 fear on mental health among college students. Therefore, we aimed to conduct a systematic review and meta-analysis that quantitatively synthesized the fear among college students during the COVID-19 pandemic.

Methods

PubMed, EMBASE, CINAHL, and PsycINFO electronic databases were systematically searched to identify cross-sectional study reporting the state of COVID-19 fear examined by the Fear of COVID-19 Scale (FCV-19S) published up until November 20, 2021. Methodological quality was complied with the evaluation criteria of the Agency for Healthcare Research and Quality. The random effects model was employed to estimate the pooled mean of FCV-19S score. Subgroup analysis and meta-regression analysis were also conducted. Publication bias was assessed by Begg's test and funnel plot.

Results

A total of 16 studies with a sample size of 11,872 were included. A pooled mean of FCV-19S score was 17.60 [95% confidence interval (CI): 16.41–18.78]. The mean of COVID-19 fear in women (17.11, 95% CI: 16.59–17.64) was higher than that in men (15.21, 95% CI: 14.33–16.08). The highest and lowest pooled means of FCV-19S score were observed in the studies conducted in multiple countries that include Israel, Russian, and Belarus (21.55, 95% CI: 20.77–22.33) and in Europe (16.52, 95% CI: 15.26–17.77), respectively. No significant publication bias was detected by Begg's test.

Conclusions

College students experienced a moderate level of fear caused by COVID-19 pandemic. It is necessary to design and implement prevention programs that target the mental health of college students.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287017, identifier: CRD42021287017.

Psychological Distress and Protective Behaviors During the COVID-19 Pandemic Among Different Populations: Hong Kong General Population, Taiwan Healthcare Workers, and Taiwan Outpatients

PURPOSE

The novel coronavirus disease 2019 (COVID-19) caused psychological distress and changed human living styles. However, rare studies have examined the psychological distress and protective behaviors across different populations. Therefore, the present study aimed to assess psychological distress, protective behaviors, and potential predictors of psychological distress and protective behaviors across the Hong Kong general population, Taiwan healthcare workers, and Taiwan outpatients.

METHODS

A cross-sectional design was used to recruit participants from Hong Kong and Taiwan. Telephone interviews were carried out for Hong Kong participants (n = 1,067; 30.2% male participants); online surveys were used for Taiwan healthcare workers (n = 500; 8.0% male participants) and Taiwan outpatients (n = 192; 32.8% male participants). All the participants completed questions on psychological distress and protective behaviors. Multiple linear regressions and multivariable logistic regressions were employed to explore the potential predictors of psychological distress and protective behaviors, respectively.

RESULTS

Hong Kong participants had significantly lower levels of psychological distress than Taiwan participants [mean (SD) = 0.16 (0.39) vs. 0.47 (0.59) in healthcare workers and 0.46 (0.65) in outpatients; p < 0.001]. Hong Kong participants (51.7%) and Taiwan outpatients had more people showing fear of COVID-19 (52.0%) than Taiwan healthcare providers (40.8%; p < 0.001). Moreover, Hong Kong participants engaged the most in protective behaviors, followed by Taiwan healthcare providers and Taiwan outpatients (p < 0.001). Moreover, being a female, fear of COVID-19 and worry about personal savings were associated with protective behaviors in general.

CONCLUSIONS

Despite the greater COVID-19 severity and fear of COVID-19 in Hong Kong, the general population in Hong Kong experienced less psychosocial distress with higher compliance to protective behaviors than the other groups in Taiwan.

Lingering effects of COVID-19 on the mental health of first-year university students in Japan

Background

The coronavirus disease 2019 (COVID-19) pandemic is continuing unabated in Japan, as of October 2021. We aimed to compare first-year university students’ psychological distress before the pandemic in 2019, during the pandemic in 2020, and one year after the onset of the pandemic, in 2021.

Methods

The study conducted online surveys over three years from April to May each year. Participants were 400 first-year students in 2019, 766 in 2020, and 738 in 2021. We examined differences in scores on the Counseling Center Assessment of Psychological Symptoms—Japanese version (CCAPS-Japanese) between the three years using a one-way analysis of variance, and differences in the CCAPS-Japanese critical items using chi-squared test and residual analysis.

Results

The average scores on the Depression and Generalized Anxiety subscale in 2021 were significantly higher than those in 2020, but remained the same as in 2019. The Academic Distress subscale score in 2020 was the worst compared to 2019 and 2021. Meanwhile, the number of students who experienced severe suicidal ideation increased year by year from 2019 to 2021.

Conclusion

The mean mental health of first-year university students worsened after the onset of the COVID-19 pandemic, and recovered to the pre-pandemic level over the next two years. However, the number of high-risk students with suicidal ideation continued to increase. A system is required for early detection and support for students at high risk of mental health issues.