The Prevalence and Correlative Factors of Depression Among Chinese Teachers During the COVID-19 Outbreak

The long-term effects of perceived instructional leadership on teachers' psychological well-being during COVID-19

The COVID-19 outbreak led to widespread school closures and the shift to remote teaching, potentially resulting in lasting negative impacts on teachers' psychological well-being due to increased workloads and a perceived lack of administrative support. Despite the significance of these challenges, few studies have delved into the long-term effects of perceived instructional leadership on teachers' psychological health. To bridge this research gap, we utilized longitudinal data from 927 primary and secondary school teachers surveyed in two phases: Time 1 in mid-November 2021 and Time 2 in early January 2022. Using hierarchical linear modeling (HLM), our findings revealed that perceptions of instructional leadership, especially the "perceived school neglect of teaching autonomy" at Time 1 were positively correlated with burnout levels at Time 2. Additionally, burnout at Time 2 was positively associated with psychological distress and acted as a mediator between the "perceived school neglect of teaching autonomy" and psychological distress. In light of these findings, we recommend that schools prioritize teachers' teaching autonomy and take proactive measures to mitigate burnout and psychological distress, aiming for the sustainable well-being of both teachers and students in the post-pandemic era.

Impact of COVID-19 infection experience on mental health status of intensive care unit patients' family members: a real-world study

PURPOSE

Family members of patients hospitalized in intensive care unit (ICU) are susceptible to adverse psychological outcomes. However, there is a paucity of studies specifically examining the mental health symptoms in ICU patients' family members with a prior history of coronavirus disease 2019 (COVID-19) infection.

AIM

This study aimed to investigate mental health status and its influencing factors of ICU patients' family members with previous COVID-19 infection experience in China.

DESIGN

Nationwide, cross-sectional cohort of consecutive participants of family members of ICU patients from 10 provinces randomly selected in mainland China conducted between October 2022 and May 2023.

METHODS

The basic information scale, Self-rating depression scale, Self-rating Anxiety Scale, Impact of Event Scale-Revised, Pittsburgh sleep quality index, Perceived Stress Scale, Connor-Davidson resilience scale, Simplified Coping Style Questionnaire were employed to explore mental health status among participants.

RESULTS

A total of 463 participants, comprising 156 individuals in Covid-19 family member cohort (infection group) and 307 individuals in control family member cohort (control group), met inclusion criteria. The infection group exhibited significantly higher incidence of composite mental health symptoms compared to control group (P = 0.017). Multivariable logistic regression analysis revealed that being female, engaging in physical/mental labor, residing in rural areas, and having children were identified as risk factors for the development of depression, anxiety, and post-traumatic stress disorder symptoms, while medical history of surgery was protective factor. A predictive model demonstrated a favorable discriminative ability and excellent calibration.

CONCLUSION

COVID-19 infection experience regarded as new traumatic stressors worsen mental health status of ICU patients' family members.

The effect of childhood trauma on suicide risk: the chain mediating effects of resilience and mental distress

BACKGROUND

Suicide is the fourth leading cause of death among young people aged 15-29 years. A large number of studies have found that mental disorder in adulthood is closely related to childhood trauma, and the relationship between childhood trauma and suicide risk is influenced by resilience and mental distress. This study aimed to explore the effects of childhood trauma on suicide risk among young people and the potential roles of resilience and mental distress in the relationship between childhood trauma on suicide risk.

METHODS

A cross-sectional survey was conducted among 742 young adults who were in graduate school stage from multiple provinces and cities in China. The Childhood Trauma Questionnaire (CTQ-Short Form), Connor-Davison Resilience Scale (CD-RISC) and Suicide Behavior Questionnaire-Revised (SBQ-R) were used to measure young adults' childhood trauma, resilience and suicide risk, respectively. 9-items Patient Health Questionnaire (PHQ-9) and 7-items self-report Generalized Anxiety Disorder Scale (GAD-7) were used together to measure mental distress. Correlation analysis was performed to explore the initial relationships among the main variables. Structural equation modeling (SEM) was conducted to examine the chain mediating effects of resilience and mental distress in the relationship between childhood trauma and suicide risk.

RESULTS

The structural equation modeling produced goodness of fit indices (χ2 /df = 3.668, p < 0.001, RMSEA = 0.060, NFI = 0.959, CFI = 0.969, GFI = 0.969, TLI = 0.955). Childhood trauma significantly predicted suicide risk (β = 0.232, p < 0.001) and mental distress (β = 0.181, p < 0.001), which had negative effect on resilience (β = -0.233, p < 0.001). Resilience negatively affected mental distress (β = -0.483, p < 0.001) and suicide risk (β = -0.142, p = 0.001), while mental distress positively associated with suicide risk (β = 0.219, p < 0.001).

CONCLUSION

The current study revealed that resilience and mental distress played chain-mediating roles in the relationship between childhood trauma and suicide risk. This suggests that we should view the suicide risk of graduate students from a comprehensive perspective.

Exploratory graph analysis on the Connor-Davidson Resilience Scale (CD-RISC) among older adults in China

It is important for healthy aging to understand resilience in depth. This study aims to examine the dimensional structure underlying the Connor-Davidson Resilience Scale (CD-RISC) among Chinese older adults. Exploratory Graph Analysis (EGA) was used to evaluate the dimensional structure of CD-RISC in two large samples: training sample (n = 11,493) and cross-validation sample (n = 7662). Then, Confirmatory Factor Analysis (CFA) was used to compare the fit of the theoretical dimensions with the EGA dimensions. Finially, Generalized Linear Model was used to examine the association between resilience scores and self-rated health (SRH) after controlling other covariates in order to evaluate the predictive value of the EGA dimensions. The EGA indicated two demensions(named foresight and self-adjustment) of the 25-item CD-RISC. The CFA comparison found that the two-demension structure of CD-RISC fit significantly better than the theoretical three-demension structure. After controlling for sociodemographic characteristics, generalized linear model showed that the EGA dimensions has better protective value with SRH. Compared with older adults with lowest quartile of foresight, those with second (odds ratio, OR = 0.68, 95% CI = 0.62 ~ 0.75), third (OR = 0.50, 95% CI = 0.45 ~ 0.56) and fourth quartile (OR = 0.42, 95% CI  =  0.37 ~ 0.48) of foresight had lower odds ratio of poor SRH. Similarly, older adults with the second (OR = 1.11, 95% CI = 1.01 ~ 1.23) and fourth (OR = 0.79, 95% CI = 0.69 ~ 0.90) quartile of self-adjustment also had lower OR of poor SRH than those with lowest quartile of self-adjustment. These findings show that EGA outperforms the traditional methods, which may be helpful to understand resilience deeply. CD-RISC should be interpreted into two aspects among community-dwelling older adults in China, highlighting the significance of the practical value and cultural context of resilience.

Anxiety, Depression, Perceived Stress, and Burnout Among Chinese Researchers: A Cross-Sectional Nationwide Study

Purpose

Depression and anxiety have a significant impact on an individuals' work and personal life alike. The mental health of researchers is a significant concern worldwide. This study investigated the mental health status of Chinese researchers specifically and explored the moderating effects of perceived stress on the influence of low self-accomplishment on anxiety and depression.

Methods

The online survey platform "Survey Star" was used to create a questionnaire to be distributed to researchers, with 949 questionnaires retrieved. The general information questionnaire, 10-item Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Maslach Burnout Inventory General Survey (MBI-GS) were used for this investigation. Pearson's correlation analysis was performed to investigate correlations among the relevant variables. Model 8 of PROCESS 3.3 program was used to analyze the moderating effects of perceived stress.

Results

Among the 949 participants, 570 (60.1%) reported symptoms of depression and 431 (45.4%) had symptoms of anxiety, with about one in six reporting symptoms of self-harm or suicidal ideation. Perceived stress was found to moderate the effect of low self-accomplishment on depression and anxiety.

Conclusion

Here we show that researchers exhibit a high rate of depression and anxiety symptoms. Perceived stress is also shown to play a moderating role on the influence of low self-accomplishment on anxiety and depression. Thus, reducing perceived stress levels can help to improve the mental health of researchers.

Interrelationships between dissatisfaction with teaching work and depressive symptoms: Structural equation modelling

The objective of this article is to evaluate the interrelationships of factors associated with depressive symptoms (DS) in teachers, considering dissatisfaction with the teaching job as a possible mediator. This was a cross-sectional study using data from 700 teachers from the public school system of a Brazilian municipality. The outcome of interest was DS, as assessed using the Beck Depression Inventory (BDI). Direct and indirect interrelationships between the outcome and dissatisfaction with work, age, income, lifestyle and adiposity were tested. These variables composed the operational model tested by structural equation modelling. Older age (β=0.12) and greater dissatisfaction with work (β=0.12) were directly associated with DS. A more favourable lifestyle (β=-0.60) and adiposity (β=-0.10) were associated with a lower occurrence of DS. The variables lifestyle (β=-0.06) and adiposity (β=-0.02) also had negative indirect effects on DS, mediated by job dissatisfaction. The structural equation model tested identified interrelationships that influenced DS. Dissatisfaction with teaching work was associated with DS and mediated the relationship of other factors with such symptoms.

Psychological distress among teaching staff during the COVID-19 pandemic: A transdiagnostic perspective on profiles of risk and resilience

Teaching staff are especially vulnerable to COVID-19-related stress, due to the significant demands they have experienced. Yet, many have shown resilience-good mental health despite stress exposure. The current study used a person-centered approach to identify distinct profiles according to individual differences in psychosocial risk and protective factors. Latent Profile Analysis and ANOVAs were employed among 350 Israeli teaching staff during the fourth wave of COVID-19. Two distinct profiles, "risk" (55%) and "resilience" (45%) were identified. While groups showed no differences in COVID-19-related stress outcomes, they consistently differed in their psychological reaction to COVID-19 (psychopathology, compassion fatigue, and compassion satisfaction).

The Impact of the COVID-19 Pandemic on the Mental Health of Teachers and Its Possible Risk Factors: A Systematic Review

(1) Objective: The objective was to analyze the development of psychiatric pathologies/burnout syndrome and their possible risk factors in teachers in the context of the COVID-19 pandemic. (2) Methods: A qualitative systematic review was carried out, according to the PRISMA protocol, in the PubMed, Scopus, and Web of Science databases using a combination of the following descriptors [MeSH]: "mental health", "mental disorders'', "covid-19" and "school teachers''. Articles selected were written in English, Portuguese and Spanish, published between November 2019 and December 2022. (3) Results: The most common psychiatric pathologies were generalized anxiety disorders and depression. Burnout syndrome was also quite prevalent. Of the 776 articles identified, 42 were selected after applying the eligibility criteria. Although there is variability among the analyzed studies, the risk factors most correlated with increased morbidity in teachers were: (i) being female; (ii) age below the fifth decade of life; (iii) pre-existence of chronic or psychiatric illnesses before the pandemic; (iv) difficulty in adapting to the distance education model; (v) family/work conflicts; (vi) negative symptoms caused by the pandemic. (4) Conclusions: Therefore, the COVID-19 impact on mental health appears to be more common in female teachers in their fifth decade of life and with pre-existing psychiatric comorbidities. However, prospective studies are needed to better map this situation.

The Effects of Cognitive Fusion on Depression in Primary School Principals During the COVID-19 Pandemic: The Mediating Role of Psychological Vulnerability and the Moderating Role of Self-Esteem

Purpose

The COVID-19 pandemic had triggered a serious crisis that had brought stress and challenges to primary school principals, as well as having a dramatic impact on their mental health. This study explored the relationship between cognitive fusion and depression among primary school principals during COVID-19, as well as the mediating role of psychological vulnerability and the moderation role of self-esteem in this process.

Patients and Methods

Cognitive Fusion Questionnaire (CFQ), Center for Epidemiological Studies Depression Scale (CES-D), psychological vulnerability scale, and self-esteem scale were used to measure 279 rural primary school principals. The data were analyzed by adopting Pearson's correlations and moderated mediation analysis.

Results

The results revealed that: (1) There were significant relationships among cognitive fusion, depression, psychological vulnerability and self-esteem. (2) The results showed that psychological vulnerability mediated the link between cognitive fusion and depression. (3) Self-esteem moderated the associations between cognitive fusion and depression, and also moderated the associations between cognitive fusion and psychological vulnerability. The relationship between cognitive fusion and depression was weaker for primary school principals with high levels of self-esteem. In contrast, the relationship between cognitive fusion and psychological vulnerability was stronger for primary school principals with low levels of self-esteem.

Conclusion

Psychological vulnerability played a mediating role in the relationship between cognitive fusion and depression. Moreover, self-esteem moderated the effect of cognitive fusion on depression, and also the effect of cognitive fusion on psychological vulnerability.

Impact of the COVID-19 pandemic on risk of burn-out syndrome and recovery need among secondary school teachers in Flanders: A prospective study

Background

Due to the COVID-19 pandemic, schools were closed, teachers had to teach from home and after a while, they had to return to the classroom while the pandemic was still on-going. Even before the pandemic, teachers were already more at risk for burn-out syndrome compared to the general population. Furthermore, not much research pertaining to this population has been carried out during the pandemic and so the impact of the pandemic on teachers' risk of burn-out syndrome and recovery need remains unclear. The aim of the current study was to fill this knowledge gap and map out the impact on risk of burn-out syndrome and recovery need at different time points during the pandemic.

Methods and findings

At baseline, 2,167 secondary school teachers in Flanders were included in this prospective study. Questionnaire data were obtained at ten different time points between September 2019 and August 2021. To assess risk of burn-out syndrome and its dimensions, the Utrecht Burn-out Scale for Teachers was administered. Need for recovery was assessed using questions adopted from the Short Inventory to Monitor Psychosocial Hazards. The results revealed an initial positive effect of the first lockdown (Mar/Apr 2020) with a decrease in risk of burn-out syndrome [Odds ratio (OR) Jan/Feb 2020-Mar/Apr 2020 = 0.33, p < 0.001], emotional exhaustion (EMM Jan/Feb 2020-Mar/Apr 2020 = -0.51, p < 0.001), depersonalization (EMM Jan/Feb 2020-Mar/Apr 2020 = -0.13, p < 0.001) and recovery need [Estimated marginal mean (EMM) Jan/Feb 2020-Mar/Apr 2020 = -0.79, p < 0.001]. No significant effect on personal accomplishment was found (p = 0.410). However, as the pandemic went on, higher risk of burn-out syndrome, emotional exhaustion, depersonalization and recovery need, and lower personal accomplishment were observed.

Conclusions

Despite the initial positive impact on risk of burn-out syndrome, its dimensions and recovery need, a negative long-term impact of the COVID-19 pandemic became visible. This study highlights once again the importance for interventions to reduce teachers' risk of burn-out syndrome, especially in such difficult times as a pandemic.

Teachers' Well-Being and Associated Factors during the COVID-19 Pandemic: A Cross-Sectional Study in Hong Kong, China

School teachers have faced many challenges due to the coronavirus disease-2019 (COVID-19) pandemic and public health-related containment measures. Recent studies have demonstrated high levels of stress and mental health issues among school teachers. To better understand teacher well-being and inform practices to support them in the face of the ongoing pandemic, we aimed to assess perceived stress, well-being and associated factors among school teachers in Hong Kong, China. For this cross-sectional study, we employed a self-reported questionnaire to assess teacher well-being as an indicator of mental health. Drawing on quantitative data obtained from 336 teachers in Hong Kong from April 2021 to February 2022, we assessed workloads, work-related sense of coherence, perceived stress, secondary burnout symptoms (i.e. intensification of work and exhaustion related to work situation), self-endangering work behaviours and satisfaction with work. Bivariate and multivariate analyses were performed to examine the associations between well-being, demographic and work characteristics. A high percentage (87.6%) of teachers had high levels of perceived stress, which was positively associated with extensification of work (r = 0.571, p < 0.01), intensification of work (r = 0.640, p < 0.01) and exhaustion related to work situation (r = 0.554, p < 0.01). A multilinear regression model adjusted for age and gender was computed to detect predictors of teachers' well-being index values (F(12, 296) = 41.405, p < 0.001, R² = 0.627). A higher WHO-5 score was associated with (1) higher teaching hours (B = 0.235, 95% CI = 0.093, 0.413, p = 0.002); (2) higher work-related sense of coherence (B = 2.490, 95% CI = 0.209, 4.770, p = 0.032); (3) higher work satisfaction (B = 5.410, 95% CI = 2.979, 7.841, p < 0.001); (4) lower level of exhaustion related to work situations (B = -9.677, 95% CI = -12.279, -7.075, p < 0.001); and (5) lower level of psychosomatic complaints (B = -4.167, 95% CI = -6.739, -7.075, p = 0.002). These findings highlight the critical need to allocate more attention and resources to improve the mental health of school teachers in Hong Kong. The findings can also inform the development of psychological and organisational interventions and support mechanisms for teachers during the prolonged COVID-19 pandemic and in preparation for future stressful scenarios. Safeguarding the well-being and mental health of teachers is important for improving the quality of teaching and learning environments and the mental health of school students.

COVID-19 pandemic-related anxiety, stress, and depression among teachers: A systematic review and meta-analysis

BACKGROUND

As millions of teachers have been forced to rely upon remote teaching due to the closure of schools during the COVID-19 pandemic. It is particularly important to understand the extent to which teacher's psychological wellbeing has been affected by this global health crisis.

OBJECTIVE

The aim of this comprehensive systematic review and meta-analysis was twofold: 1) ascertain the prevalence of stress, anxiety, depression among teachers during the COVID-19 outbreak; 2) identify the associated factors of these psychological wellbeing domains of the teachers.

METHODS

Academic Search Premier, Eric, PsycInfo, Scopus, and Web of Science were searched for articles published from December 2019 and July 2021, using search terms including "COVID-19" "anxiety" "depression" "stress", and "teachers".

RESULTS

This study included 54 studies synthesising data from 256,896 teachers across 22 countries. The meta-analysis showed higher prevalence of stress (62.6%, 95% Confidence Interval [CI]: 46.1-76.6), compared to anxiety (36.3%, 95% CI: 28.5-44.9) and depression (59.9%, 95% CI: 43.4-74.4) among teachers. Teachers' experiences of these psychological issues were associated with various socio-demographic and institutional factors, including gender, nature of online teaching, job satisfaction, teaching experience, and the volume of workload. Additionally, several protective factors, such as regular exercises and provision of technical support for online teaching, reduced teachers' negative psychological experiences.

CONCLUSION

There is a need for authorities to formulate educational policies to improve teachers' wellbeing at the time of global crisis. Special attention should be paid to assist female teachers in overcoming physical and mental stressors.

Teachers’ emotional well-being during the SARS-CoV-2 pandemic with long school closures: A large-scale cross-sectional survey in Northern Italy

Objectives

This study aimed to evaluate the magnitude of emotional burden on teaching staff during the SARS-CoV-2 pandemic in a significantly impacted region. In addition, the correlates of emotional burden were analysed to enable the design of targeted interventions.

Study design

This study was a cross-sectional survey.

Methods

An electronic survey was administered to the teaching staff at public schools and kindergartens in a specific geographical area. Cross-sectional assessments of pandemic-specific variables were performed using the Pandemic Fatigue Scale, the Depression Anxiety Stress Scale (DASS)-21, the Satisfaction with Life Scale, and the Resilient Coping Scale. DASS-21 results were compared with results from a parallel survey that was representative of the local general population.

Results

In total, 3251 teaching staff members participated in the survey. Teachers showed a higher emotional burden for depression, anxiety and stress than the general population during the pandemic. According to a linear regression model, this burden is correlated with the language in which the questionnaires were answered, mistrust towards institutions, specific SARS-CoV-2 anxiety, past infection with SARS-CoV-2, avoidance of information about the pandemic and pandemic fatigue; emotional burden was negatively correlated with measures for life satisfaction, resilience and team atmosphere. Some independent variables were shown to contribute differentially to the variance of depression, anxiety or stress.

Conclusions

Emotional distress during the pandemic among teachers is higher than in the general population and correlates with variables that could, at least in principle, be targeted for specific interventions.

Schoolteachers' Resilience Does but Self-Efficacy Does Not Mediate the Influence of Stress and Anxiety Due to the COVID-19 Pandemic on Depression and Subjective Well-Being

Objectives: In the current coronavirus disease (COVID-19) pandemic, schoolteachers experience stress from addressing students or performing school tasks that may result in burnout. This study aimed to observe whether teachers' stress and anxiety due to the pandemic can influence their depression or psychological well-being and examine whether their resilience or self-efficacy mediates this association. Methods: During March 4-15, 2021, 400 teachers participated and responded voluntarily to an online survey that included the Stress and Anxiety to Viral Epidemics-9 items (SAVE-9), the Teacher-Efficacy Scale, the Brief Resilience Scale (BRS), the WHO-5 Well-Being Index, and the Patients Health Questionnaire-9 items. Results: High psychological well-being of teachers in COVID-19 pandemic era was expected by a low SAVE-9 score (aOR = 0.95; 95% CI, 0.91-0.99), a high level of self-efficacy (aOR = 1.03; 95% CI, 1.01-1.06), and a high BRS score (aOR = 1.18; 95% CI, 1.10-1.27). Moreover, teachers' resilience mediated the effects of stress and anxiety from the COVID-19 pandemic on their subjective well-being or depression. Conclusions: Schoolteachers' subjective well-being and depression were influenced by high levels of stress and anxiety of the viral epidemic, and their resilience mediated this relationship in this COVID-19 pandemic era.