Family and Academic Stress and Their Impact on Students' Depression Level and Academic Performance

Exploring the Correlation of Physiological Stress Signals with Student Exam Performance: A Preliminary Study

Stress responses in real-world settings are less studied compared to controlled laboratory environments, limiting our understanding of their impact on cognitive performance. This study investigates the relationship between physiological stress signals and academic performance using an open-access dataset of 10 students assessed across three exam sessions (Midterm 1, Midterm 2, and Final Exam). Physiological measures, including electrodermal activity (EDA), heart rate (HR), and skin surface temperature (TEMP), along with exam grades, were analyzed using traditional hypothesis testing, bootstrap method, correlation analysis, and regression tree modeling. To address the small sample size, we validated traditional hypothesis test results with the bootstrap method, and both approaches were compatible. Hypothesis testing revealed no significant differences in physiological measures across exam sessions, supporting the null hypothesis. Grades differed significantly between the final exam and both midterms (p < 0.05). Stress fluctuations were also analyzed across three periods (beginning, middle, and end) for each exam, revealing temporal response variations. Correlation analysis showed a moderate negative relationship between EDA and HR (r = - 0.504, p < 0.01) and a weak positive relationship between EDA and TEMP (r = 0.417, p < 0.05), both intensifying during the final exam. Regression analysis explained 78% of the variance in grades (R2 = 0.78), with regression tree modeling identifying lower skin temperature (< 28 °C) and higher EDA (≥ 0.19) as predictors of poorer performance. These findings underscore the interplay between physiological stress responses and academic outcomes, emphasizing the need for further research and interventions to support student success.

Developmental Trajectories of Intrinsic and Extrinsic Goals From Early to Late Adolescence and the Association with Internalizing and Externalizing Problems

Although numerous studies have explored the causes and consequences of intrinsic and extrinsic life goals, the developmental trend of life goals during adolescence has not been well understood. To address this research gap, this study explored the developmental changes of the pursuit of intrinsic and extrinsic goals during early, middle, and late adolescence, and examined the relation between life goals and internalizing/externalizing problems from a developmental perspective. A total of 4703 Chinese adolescents from primary (N = 1819, 47.8% girls, Mage T1 = 9.34, SDage T1 = 0.58), middle (N = 1525, 47.5% girls, Mage T1 = 12.47, SDage T1 = 0.59), and high school (N = 1646, 51.9% girls, Mage T1 = 15.45, SDage T1 = 0.65) participated in this two-year, three-wave longitudinal study. The results revealed that the pursuit of intrinsic goals increased among primary school students, but decreased among middle and high school students. Conversely, the pursuit of extrinsic goals exhibited a consistent increase among adolescents in primary, middle, and high school. Girls have higher initial levels of intrinsic goals than boys in primary school, and boys' intrinsic goals declined faster than girls' in middle school. Additionally, the initial level and developmental rate of intrinsic goals among three developmental stages were significantly associated with internalizing/externalizing problems, with lower initial level, slower growth rate, and faster decline rate being associated with more internalizing and externalizing problems. The significant association between the initial level and developmental rate of extrinsic goals and internalizing/externalizing problems were mainly observed among late adolescents, with higher initial level and growth rate being associated with more internalizing and externalizing problems. These findings delineate the differences in developmental trends between intrinsic and extrinsic goals, underscore the robust relation between intrinsic goals and internalizing/externalizing problems, and figure out the development-stage differences in the relation between extrinsic goals and internalizing/externalizing problems.

Links Between Academic Stress and Prosocial Outcomes: The Moderating Role of Maternal Support

The goal of the current study was to examine the links between academic stress, maternal support, and three different forms of prosocial behaviors (i.e. in-group prosocial behaviors, out-group prosocial behaviors, and civic engagement). Additionally, we also examined the interactive effect between academic stress and maternal support on prosocial behaviors. Participants were 142 young adult college students (M age = 20.82 years; range = 18-25 years; 81.7% women; 65.2% reported identifying as racially White; 9.9% Black; 7.8% Asian; 5.7% Native; and 49.3% identified their ethnicity as Latino/a). Participants reported on their academic stress levels, perceptions of their maternal support, and their tendencies to engage in the three forms of prosocial behaviors. The results (see Figure 1) demonstrated that academic stress was not associated with prosocial outcomes. Maternal support was positively associated with in-group prosocial behaviors. There was also one significant interaction that emerged. The interaction between academic stress and maternal support positively predicted civic engagement, such that when maternal support was low, academic stress was positively associated with civic engagement. The discussion focuses on the nuanced associations between these variables, with a focus on the potentially protective role of civic engagement specifically for young adults seeking social connection and belonging.

Resilience in allied health undergraduate education: a scoping review

PURPOSE

Students of allied health disciplines deal with daily challenges. Without methods to mitigate stress, a decline in academic and clinical performance may result. This scoping review aims to examine the current evidence for the efficacy of interventions for enhancing resilience for allied health students.

MATERIALS AND METHODS

Medline, Emcare and Cochrane Library were systematically searched for literature published until October 2022. The search included Quantitative studies which employed a pre-post or controlled study design to evaluate an intervention to improve resilience for university students in medical radiation, pharmacy, optometry, physiotherapy and podiatry. Screening and data extraction was conducted independently by two reviewers. Critical appraisal was conducted using Joanna Briggs Institute (JBI) critical appraisal tools. Seven studies were included.

RESULTS

A range of resilience interventions were discovered in terms of the frequency and duration, method of implementation including didactic and online learning. Statistically significant findings were found in most controlled trials and pre-post studies. Interventions to enhance resilience are effective within allied health curriculum.

CONCLUSIONS

The evidence that resilience can be significantly influenced by an intervention suggests that stakeholders should spend more time on designing and piloting interventions within their context. Future research should look to assess longer term and clinical related outcomes.

The Holistic Effect of Complementary Interventions in Reducing Stress in College Students

The purpose of this research was to examine the holistic effects of combined complementary therapies in reducing stress in college students. This convergent mixed-method study provided aromatherapy, massage, and meditation music sessions to college students (N = 50) just before finals week. Paired t-tests analyzed pre-session and post-session perceived stress and anxiety as well as objective physiological measures, including salivary cortisol, heart rate, and blood pressure. There was a significant difference in the scores for perceived stress before and after the sessions, t(49) = 4.72, p < .001, as well as pre-anxiety and post-anxiety, t(49) = 10.27, p < .001. Additionally, salivary cortisol levels significantly reduced from pre-session to post-session t(49) = 2.76, p = .008; and a significant reduction in heart rate from pre-session to post-session, t(49) = 3.73, p < .001. This study demonstrates that 20 min of brief complementary interventions can alter students' subjective holistic health perspectives, with objective physiological data confirming changes that promote health and wellbeing.

Academic Pressure and Psychological Imbalance in High School Students: Predictors of Depression via Polynomial Regression and Response Surface Analysis

Objective

The purpose of this study was to explore how the congruence between academic pressure and psychological imbalance affects depressive symptoms in adolescents and to further explore grade-level differences in these effects among high school students.

Methods

The study population consisted of 29,975 high school students from 20 schools in Liuyang City, Hunan Province. The Mental Health Scale for Secondary School Students (MSSMHS) and Self-Depression Scale (SDS) were used to assess academic pressure, psychological imbalance and depressive symptoms. The effects of academic pressure and psychological imbalance were examined by polynomial regression and response surface analysis.

Results

The results showed that the lowest level of academic pressure (F = 35.99, p < 0.001), psychological imbalance (F = 54.50, p < 0.001), and depressive symptoms (F = 9.36, p < 0.001) was found in repeaters, while the highest level was found in twelfth graders. Academic pressure was positively associated with psychological disequilibrium, and both were positively associated with adolescent depressive symptoms. Furthermore, when academic pressure and psychological imbalance are aligned, adolescent depressive symptoms increase with the first two. In addition, adolescent depressive symptoms decreased as the difference between academic pressure and psychological imbalance increased.

Conclusion

This study elucidates the non-linear relationship between academic pressure, psychological imbalance and depressive symptoms, and that adopting appropriate strategies to reduce academic pressure and adjust psychological balance is crucial for the prevention of depression in adolescents.

Psychological well-being and academic performance of Ukrainian medical students under the burden of war: a cross-sectional study

Introduction

The mental health of medical students is a key factor for academic performance and the delivery of high-quality medical care in the future. Globally, medical students face numerous challenges that can affect their education. Living and studying facing the war has a crucial influence on medical students' education and daily life. The study aimed to determine the psychological well-being and academic achievements of Ukrainian medical students who lived in the rear areas after the 18 months of the Russian-Ukrainian war.

Methods

The cross-sectional study was conducted at I.Ya. Horbachevsky Ternopil National Medical University. We analyzed the psychological well-being and educational achievements of medical students from the second to fifth year of Medical Faculty using the self-report scales DASS-21 and IES-R. A total of 776 students filled out the DASS-21 scale and 491 IES-R scale, respectively.

Results

Following the first 18 months of the war, 62.5, 59.6, and 58.8% of Ukrainian medical students self-reported signs of stress, anxiety, and depression, respectively. Severe and extremely severe depressive symptoms were observed in 25.6% of students, anxiety in 31.9%, and stress in 29.7%, with a higher prevalence among female students. Additionally, 44.2% of responders had significant symptoms of post-traumatic stress disorder, with the highest scores on the hyperarousal subscale (>37). Academic performance in 2023 was significantly lower compared to the pre-war period in 2019 (p < 0.001) (p = 0.000). The multiple linear regression analysis showed that academic performance was positively associated with depression (p = 0.003), hyperarousal (p < 0.001), anxiety (p = 0.03), and negatively associated with stress (p = 0.002).

Conclusion

Ukrainian medical students in rear areas are facing various challenges, with war-related stressors having a profound impact on their mental health. Our findings have shown an increasing prevalence of anxiety, stress, depression, and symptoms of post-traumatic stress disorder, all of which may negatively affect academic performance. The educational process during wartime is important for facilitating qualified medical personnel and quality healthcare. Understanding the burden of war allows for the development of wellness programs that support student mental health in conflict zones.

Mental Health Problems Among Indonesian Adolescents: Findings of a Cross-Sectional Study Utilizing Validated Scales and Innovative Sampling Methods

PURPOSE

This study aimed to estimate the prevalence of mental health problems and identify potential risk and protective exposures for adolescents in Indonesia.

METHODS

An innovative sampling approach was applied to simultaneously recruit school- and community-based adolescents aged 16-18 years old from Jakarta (urban megacity) and South Sulawesi (remote province). We used multistage cluster sampling for in-school (N = 1,337) and respondent driven sampling for out-of-school (N = 824) adolescents. Mental health was measured using two validated scales: Kessler-10 and Center for Epidemiologic Studies Depression Scale-Revised. Psychiatric interviews were conducted in a subsample (N = 196) of students from Jakarta to validate the self-report scales.

RESULTS

The estimated population prevalence of psychological distress and depression were 24.3% (95% CI = 21.5-27.2) and 12.6% (10.5-14.4) for in-school and 23.7% (20.7-26.7) and 23.5% (20.4-26.5) for out-of-school adolescents, respectively. In participants who completed a psychiatric interview, common psychiatric morbidities were social anxiety, depression, and suicidality. Compared to in-school females, male in-school adolescents reported a lower prevalence of psychological distress (16.9% (13.1-20.7) vs. 30.4% (26.4-34.4)) and depression (10.1% (7.2-13.1) vs. 14.6 (11.4-17.8)). By contrast, for out-of-school adolescents, males reported a higher prevalence of psychological distress (25.2% (21.6-28.9) vs. 20.2% (15.1-25.3)) and depression (26.3% (22.5-30.1) vs. 16.9% (11.8-21.9)). In-school adolescents who did not seek healthcare despite a perceived need were more likely to report psychological distress and depression.

DISCUSSION

Adolescent mental health problems are highly prevalent in Indonesia, with substantial variation by gender, geography, and school enrolment. This study and its approach to sampling and measurement may serve as a model to improving mental health surveillance across other settings.

Parental democratic communication and adolescent well-being in an era of loneliness: the mediating role of societal trust

Background

In an era marked by increasing loneliness, understanding the impact of parenting practices on adolescent well-being and resilience is crucial. This study investigates the relationship between parental democratic communication and key indicators of adolescent adjustment and well-being in China, with a focus on the mediating role of societal trust.

Objective

The study aimed to examine the direct effects of parental democratic communication on Chinese adolescents' subjective well-being and to explore the mediating roles of societal trust in this relationship.

Methods

Data were collected from 691 high school students as part of the 2020 Chinese Family Panel Studies (CFPS). The sample was divided into two age groups: 16-17 years old (n=493) and 18 years old (n=198). Multi-group Structural Equation Modeling (SEM) was used to analyze the data.

Results

SEM analysis revealed age-specific effects of parental democratic communication (PDC) on subjective well-being (SWB). For ages 16-17, PDC directly influenced SWB (β=0.269, p<0.001) with significant serial mediations through societal trust, negative emotion, and pleasant life experiences. For 18-year-olds, only societal trust mediated the PDC-SWB relationship (β=0.16, p<0.01). Meanwhile, the effect of societal trust is superior to that of other mediating variables in both groups. Multi-group analysis showed measurement invariance but differences in structural relationships across age groups.

Conclusions

Parental democratic communication has a direct as well as serial mediated impact on mid-adolescents' subjective well-being and an indirect impact through societal trust in late adolescence, among Chinese adolescents. These results point to a pattern we term "Societal Trust-Mediated Well-Being," which appears to wield greater influence than negative emotions or pleasant life experiences, particularly among older adolescents. These results underscore the need for developmentally tailored approaches and integrative interventions that adapt to the changing dynamics of adolescent well-being in a rapidly evolving society.

Key Factors Supporting Nursing Students' Academic Success and Recommendations to Enhance Learning Outcomes

BACKGROUND

Understanding the factors that contribute to nursing students' low self-efficacy and high stress levels is necessary to improve educational practices.

PURPOSE

To determine the impact of self-efficacy and demographic factors on nursing students' stress levels and academic success and to provide strategic recommendations for nurse educators.

METHODS

This cross-sectional study included data of 145 nursing students collected using a structured questionnaire that assesses self-efficacy, stress, and covariates. Bivariate and multivariate tests were conducted to explore potential relationships among variables.

RESULTS

The results indicated significant relationships among self-efficacy, stress, and demographic factors. While self-efficacy levels were influenced by gender and marital status, stress levels appeared to be affected by gender, age, and the academic semester. Self-efficacy and stress among nursing students were also significantly associated.

CONCLUSION

Nurse educators should develop a supportive learning environment, better mentorship programs, and effective mental health awareness to improve students' confidence and academic success.

Depression, Anxiety, and Stress Symptoms Among Students in Croatia During the COVID-19 Pandemic: A Systematic Review

Background: The COVID-19 pandemic has led to an increased fear of infection, social isolation, financial concerns, and feelings of loneliness and uncertainty. Studies reveal that the pandemic has had a significant negative impact on mental health. This systematic review aimed to investigate the prevalence of depression, anxiety, and stress symptoms among students in Croatia during the COVID-19 pandemic. Methods: A systematic review was conducted following PRISMA guidelines. A literature search was performed on August 5, 2024, using the electronic databases Scopus, PubMed, Web of Science, and PsycINFO. The search utilized the Boolean logical operator expression ('depression' AND 'anxiety' AND 'stress' AND 'COVID-19' AND 'Croatia' AND 'student'). Results: Out of one hundred and fifty-four identified studies, five met the inclusion criteria and were included in the review. The studies used the Generalized Anxiety Disorder 7-item scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Depression, Anxiety, and Stress Scale-21 (DASS-21) to assess mental health. The results indicate a high prevalence of symptoms of depression, anxiety, and stress among students in Croatia during the pandemic. Conclusion: A high prevalence of negative affective emotions was observed among students in Croatia during the pandemic. This finding underscores the importance of developing effective strategies for the early identification and management of mental disorders among students, irrespective of the pandemic's conclusion.

Unveiling the impact of school organizational justice on students' professional commitment through academic stress mediation

Accurately understanding the critical elements influencing college students' professional commitment is both an urgent practical requirement and a critical theoretical proposition in today's intensely competitive job market. In order to provide new light on career development in the context of higher education, this study intends to investigate the complex interactions among college students between perceived organizational justice, academic stress, and professional commitment. Using descriptive statistics, correlation analysis, regression analysis, and structural equation modeling, we carried out a thorough investigation of H University's full-time undergraduate students in Central China in order to thoroughly examine our hypothesis. The results show that students' professional commitment is much lower when they view organizational justice to be lacking, and that there is a partial mediating role for academic stress in this relationship. Interestingly, organizational justice has a positive correlation with professional commitment and a negative correlation with academic stress. These findings provide educators and policymakers with insightful information, indicating that, in an increasingly competitive labor market, professional commitment is largely dependent on students' ability to manage their academic stress and develop a sense of organizational justice. This study adds a new understanding of career development in higher education settings by merging professional commitment research with organizational justice theory. It also has significant implications for educational practices and career support measures.

Academic stress among students in Vietnam: a three-year longitudinal study on the impact of family, lifestyle, and academic factors

Objective

Academic stress is associated with mental health disorders, notably depression and anxiety among students. Mitigating stress can decrease the incidence of mental health disorders and improve student well-being. This study explored factors influencing academic stress among secondary school students in Vietnam.

Materials and Methods

A three-year longitudinal study was conducted using a self-reported questionnaire with 611 students from four secondary schools in Hue City, Vietnam. Academic stress was evaluated using the Educational Stress Scale for Adolescents (ESSA). Family factors, including the number of siblings and parental educational levels; lifestyle factors, including physical activity and sleep; and academic factors, including grade point average and attending extra classes were evaluated. Linear regression models were used to analyze the associations between the ESSA scores at follow-up and family, lifestyle, and academic factors at baseline.

Results

A total of 341 students completed both the baseline and follow-up surveys and answered the questions required for this analysis. The mean ESSA score of 341 students increased from 46.4 ± 7.6 (mean ± SD) to 53.5 ± 10.8, from 2018 to 2021. The multivariate model revealed that the number of siblings, higher father's educational attainment level, female gender, lower academic scores, and attending extra classes were associated with overall academic stress. In contrast, no associations were observed between the variables of lifestyle, parental concentration, and parental acceptance and overall academic stress.

Conclusion

The findings highlight the impact of family factors and study workload on academic stress, emphasizing the need for proper care from family and school to reduce or prevent student academic stress and provide them with a comfortable and healthy learning environment.

Sex Differences in Risk Factors for Generalized Anxiety Disorder in Korean Adolescents

Objectives

This study aimed to examine sex differences in the risk factors associated with generalized anxiety disorder (GAD) among Korean adolescents to provide insights for drafting more effective prevention strategies.

Methods

Data from 51845 middle and high school students in the 18th Korea Youth Risk Behavior Web-based Survey were analyzed. GAD was assessed using the 7-item Generalized Anxiety Disorder tool, and factors such as grade, academic performance, economic status, living arrangements, smoking, drinking, sexual experience, and physical activity were included. The prevalence of GAD and its association with these factors were compared between male and female students using chi-square tests and logistic regression. Odds ratios were compared statistically to identify sex-specific differences.

Results

GAD prevalence was higher among girls (42.1%) than boys (30.1%). Both sexes showed increased GAD risk with lower academic performance, lower economic status, smoking, drinking, and sexual experience. Boys living apart from their families had a higher GAD risk, but this was not significant for girls. Additionally, smoking and drinking were associated with a higher increase in GAD risk in girls than in boys.

Conclusion

This study underscores the importance of considering sex differences in the prevention of GAD among adolescents. Tailored sex-specific interventions are crucial for effective prevention and management of GAD in Korean adolescents.

International students' perceived quality of university health centre services: an exploratory sequential mixed methods study

AIM

This study aims to investigate international students' perspectives on service quality and analyse factors contributing to the perceived service quality of the university health centre.

BACKGROUND

International students are at increased risk of experiencing poor mental health, isolation from families and cultures, language barriers, financial stress and academic pressures. It is important that universities support international students to enable them to complete their degrees and reach their desired level of achievement and performance. One of the supports required by international students is the availability of healthcare services. Therefore, improving the quality of services to meet international students' requirements, including healthcare services, is essential.

METHODS

A three-phase exploratory sequential mixed methods design was used. Phase 1 aims to explore international students' perceptions of primary healthcare quality by conducting in-depth interviews and focus group discussions. Data were analysed using thematic analysis. Phase 2 is to form questionnaire items based on the results of the qualitative study. The questionnaire is subject to pilot testing to measure validity and reliability. Phase 3 analyses factors influencing international students' perceived primary healthcare service quality. Multiple regression was used to analyse factors contributing to the perceived service quality of international students.

FINDINGS

The qualitative strand revealed five major themes representing the study participants' thoughts about the quality of services in the university healthcare context. Perceived quality attributes identified in this study were primarily empathy, equity, effectiveness, efficiency and safety. The quantitative strand found that 35.57% of participants consider the perceived quality of the centre as good. The highest and lowest service quality attributes were related to safety and efficiency, with a score of 21.12 ± 3.58 and 19.57 ± 4.34, respectively. The multiple linear regression analyses showed that PhD students from Health Faculty and Scholarship awardees were significantly associated with the perceived quality of healthcare services. Thus, the university management needs to improve service quality considering the diversity of international students' socio-demographic characteristics.

Comparative Analysis of Stress Levels Among Undergraduate Students at St. John's College, Agra

Background Stress is prevalent among college students, impacting their mental health and academic performance. Understanding the distribution and determinants of stress levels in students is crucial for developing effective interventions. This study aims to assess the prevalence of stress and its association with sociodemographic factors among undergraduate students at St. John's College, Agra, India. Materials and methods A descriptive cross-sectional study was conducted between August 1, 2023, and December 31, 2023, involving 160 undergraduate students from B.A., B. Com., and B.Sc. programs. Students were selected using a stratified random sampling technique. Stress levels were measured using the Perceived Stress Scale (PSS), which classifies low, moderate, and high levels. Data were collected through a validated, semi-structured questionnaire administered via Google Forms. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York), with descriptive statistics and chi-square tests used to examine associations between stress levels and sociodemographic variables. Results The study found that 103 (64.4%) of students experienced moderate stress, 34 (21.3%) reported high perceived stress, and 23 (14.4%) had low stress. A significant association was observed between stress levels and gender (p = 0.022), with female students more likely to experience high stress. Additionally, urban students reported higher stress levels than their rural counterparts (p = 0.012). However, no significant differences in stress levels were found across different courses. Conclusion The study reveals a substantial prevalence of moderate to high stress among college students, particularly among females and those from urban areas. These findings suggest the need for targeted stress management interventions to support student well-being. Further research is recommended to explore the underlying causes of stress and develop comprehensive stress reduction strategies in the student population.

Coping with Examination Stress: An Emotion Analysis

Stress is an important factor affecting human behavior, with recent works in the literature distinguishing it as either productive or destructive. The present study investigated how the primary emotion of stress is correlated with engagement, focus, interest, excitement, and relaxation during university students' examination processes. Given that examinations are highly stressful processes, twenty-six postgraduate students participated in a four-phase experiment (rest, written examination, oral examination, and rest) conducted at the International Hellenic University (IHU) using a modified Trier protocol. Network analysis with a focus on centralities was employed for data processing. The results highlight the important role of stress in the examination process; correlate stress with other emotions, such as interest, engagement, enthusiasm, relaxation, and concentration; and, finally, suggest ways to control and creatively utilize stress.

Psychological Distress Among High School Students in Bangkok Thailand

Introduction

This study investigated psychological distress among high school students in Thailand.A sample of 8,345 students from thirty-five Bangkok schools voluntarily participated, responding to a questionnaire and undergoing stress assessments. Socio-demographic factors including grade level, school scale, hometown, parental marital status, presence of siblings, gender, health conditions, online classes, and family monthly income were analyzed.

Results

Of the participants, 1,087 (13.02%) experienced psychological distress. Grade level, school scale, hometown, parental marital status, and siblings' presence showed no significant associations with distress. However, being female or transgender correlated with higher distress levels. Students with health issues and those in online classes also experienced elevated distress. Additionally, a family monthly income below 10,000 Thai Baht was associated with distress.

Conclusion

This study sheds light on factors contributing to psychological distress in high school students. It highlights the need for tailored support for vulnerable groups within the student population, emphasizing the role of educators, policymakers, and mental health professionals in addressing these challenges.

The perception and association between depression and academic stress among female undergraduate nursing students: a cross-sectional study

Introduction

Academic demands and stressors put nursing students at increasing risk of depression. The aims of the study examine the perceived level of depression and academic stress and investigate the association between these variables among nursing students in Saudi Arabia.

Methods

A cross-sectional design was used in this study. Data was collected using depression subscale from DASS-21 scale and the Academic Stress Inventory scale.

Results

A total of 237 students participated in the study. Nursing students perceived normal to mild levels of depression. Students perceived moderate levels of academic stress in all subscales, except for time management and test stress which were high. All academic stress subscales had a positive statistically significant correlation with depression. The regression model explains 49.0% of the variance in the depression scale and indicated that the main significant predictor of depression is studying in group stress, followed by self-inflected stress, study year, and sleep problem. The mean score of depression for first year students was significantly different than students in other study years.

Discussion

Nurse educators should facilitate group formation and teach students about time-management, problem-solving, negotiation, and coping strategies to deal with academic expectations and demanding situations. Understanding the causes, limiting the exposure to negative influences, and seeking support as needed are important. To enhance the quality of sleep, students should maintain a consistent sleep schedule, while avoiding stimulating activities before bedtime. Future research should focus on a longitudinal study and other variables such as quality of life, satisfaction with the quality of teaching, and support from others.

The prevalence of comorbid mental health difficulties in young people with chronic skin conditions: A systematic review and meta-analysis

Chronic skin conditions can have psychosocial and somatic implications, influencing well-being and quality of life. This systematic review and meta-analysis aimed to synthesise evidence on the prevalence of comorbid mental health difficulties in 0-25-year-olds with chronic skin conditions. A secondary aim included identifying factors associated with resilience. The narrative synthesis included 45 studies. Four meta-analyses were performed with moderate-high quality studies, one for each outcome: diagnosed mental disorders; mental health symptoms; suicidal behaviour; socio-emotional and behavioural difficulties. The pooled prevalence of diagnosed mental disorders was 1.2% (95% CI = 0.2-6.1); of mental health symptoms was 22.6% (95% CI = 18.9-26.7); of suicidal behaviour was 7.8% (95% CI = 1.4-3.1); of socio-emotional and behavioural difficulties was 20.9% (95% CI = 14.7-28.8). Findings demonstrate the pooled prevalence of comorbid mental health difficulties in youth with chronic skin conditions.

Exploring the Educational Social and Physical Activities Among Health Care Undergraduates - a Cross-Sectional Study Among Saudi Students

BACKGROUND The time spent on diverse social, physical, and educational activities among healthcare undergraduates (HCUs) tremendously impacts their academic and personal lives. Therefore, this study aimed to assess the social, physical, and educational activities among HCUs at King Saud University (KSU) in Riyadh, Saudi Arabia (SA). MATERIAL AND METHODS A cross-sectional, self-prepared, and pre-tested e-questionnaire (electronic questionnaire) based study using a convenience sampling design in a university in SA from August 21 to November 21, 2023 was conducted to assess their various activities outside of classes, using a 16-item e-questionnaire to investigate time spent on social (4 items), physical (3 items), and educational activities (3 items). RESULTS A total of 452 HCUs completed the e-questionnaires, giving a response rate of 92.62%. Of them, 50.45% were females, the median age was 23 years, and 32.08% (n=145) were medical undergraduates. About 57% of the HCUs spent 1-2 h per day on educational activities during the day, while 32.7% of the HCUs spent 2 h per day on social media, and 62.6% spent 3-4 h per day with family. The findings revealed that the 140 females spent significantly more time (1-2 h) reading and writing compared to the 117 male HCUs (P=0.001). Age was found to be associated with time spent on education by HCUs (P=0.001). CONCLUSIONS Our findings among HCUs show that most spend a significant amount of time on educational activities during the day. Undergraduates also spend time with their families and participate in other social activities.

Are social pressure, bullying and low social support associated with depressive symptoms, self-harm and self-directed violence among adolescents? A cross-sectional study using a structural equation modeling approach

BACKGROUND

More in-depth evidence about the complex relationships between different risk factors and mental health among adolescents has been warranted. Thus, the aim of the study was to examine the direct and indirect effects of experiencing social pressure, bullying, and low social support on mental health problems in adolescence.

METHODS

A school-based cross-sectional study was conducted in 2022 among 15 823 Norwegian adolescents, aged 13-19 years. Structural Equation Modelling was used to assess the relationships between socioeconomic status, social pressure, bullying, social support, depressive symptoms, self-harm and suicide thoughts.

RESULTS

Poor family economy and low parental education were associated with high pressure, low parental support and depressive symptoms in males and females. Moreover, poor family economy was associated with bullying perpetration and bullying victimization among males and females, and cyberbullying victimization among females, but not males. Low parental education was associated with bullying victimization among males, but not females. Further, high social pressure was associated with depressive symptoms among males and females, whereas high social pressure was linked to self-harm and suicide thoughts among females, but not males. Bullying victimization and cyberbullying victimization were associated with depressive symptoms, self-harm, and suicide thoughts among males and females. Bullying victimization was associated with depressive symptoms among males, but not females, whereas bullying perpetration was linked to self-harm and suicide thoughts among females, but not males. Low parental support was associated with bullying perpetration, bullying victimization, depressive symptoms, self-harm and suicide thoughts among males and females, whereas low parental support was associated with high social pressure among females, but not males. Low teacher support was associated with high social pressure and depressive symptoms. Low support from friends was associated with bullying victimization, depressive symptoms and suicide thoughts among males and females, whereas low support from friends was linked to self-harm among males, but not females. Finally, results showed that depressive symptoms were associated with self-harm and suicide thoughts among males and females.

CONCLUSION

Low socioeconomic status, social pressure, bullying and low social support were directly and indirectly associated with depressive symptoms and self-directed violence among Norwegian adolescents.

Bibliometric Analysis of Research Papers on Academic Stress (1989-2023)

This extensive study provides a comprehensive overview of the contemporary research landscape about academic stress, emphasizing on identifying the most relevant contributors and understanding prevalent trends. The analysis included 5,375 results from the PubMed database and revealed a consistent upward trajectory with fluctuations in research paper publications over the years. Network analysis and visualization were performed using the Biblioshiny app and VOSviewer software. The analysis identified that the University of Oslo has published the highest number of research papers related to academic stress. In contrast, the Netherlands, the USA, and Australia demonstrated the highest frequency of collaboration. Analysis of keywords and their co-occurrence provides an overview of the research focus and the areas associated with psychological stress due to academics. Thematic evaluation and topic trend analysis provided insights into the evolving nature of research in academic stress. The thematic map depicts two categories of themes - motor themes, including psychological stress, its epidemiology, the influence of the COVID-19 pandemic, and the mental health of university students, particularly those in medical programs; and emerging themes, including oxidative stress and risk factors, indicated evolving areas of interest. A notable observation was the scarcity of research on primary school students, signaling a gap in the existing academic stress literature. Citation analysis identified the most cited authors, countries, universities, and sources. This multifaceted examination provides a nuanced understanding of academic stress research's current state and dynamics, offering valuable insights into trends, collaborations, and thematic shifts that will guide future research in this critical field.

Deep breathing exercises in easing educational stress among Indian high school students

In this educational landscape, the pervasive issue of stress among higher secondary students has emerged as a serious matter. Acknowledging the challenges posed by educational stress, this research explores holistic and accessible interventions, with a focus on the promising avenue of deep breathing exercises known for their effectiveness in promoting relaxation and reducing stress. The study employs a quasi-experimental design, comparing an experimental group engaged in daily deep breathing exercises with a control group following a regular routine. Sixty higher secondary students in Visnagar participate through purposive sampling, adhering to specific inclusion criteria. The intervention includes a pre-tested questionnaire to assess stress levels, the implementation of daily deep breathing exercises in the experimental group, and a post-intervention stress level reassessment in both groups. The findings reveal a notable reduction in stress levels post-intervention, particularly in the experimental group practicing deep breathing exercises. Statistically significant reductions in mean stress scores underscore the effectiveness of this intervention, with the experimental group demonstrating a significantly lower mean stress score compared to the control group. This study contributes vital insights into stress management strategies for higher secondary students, highlighting the efficacy of incorporating deep breathing exercises into their routine. The observed reductions in stress levels emphasize the potential benefits of practical stress reduction techniques within the educational milieu.

Stressors and coping strategies among secondary school male students in Abha City, Saudi Arabia

Background

Stress is a biological process in which exposure to stressors is associated with bad health effects, decreased ability of disease management, and a higher likelihood for disease-related complications and comorbidities. Stress has been considered the main factor in the etiology of many diseases such as diabetes mellitus, cardiac diseases, and body aches for centuries. Students meet many stressful situations such as the need for success, academic demands, homesickness, and lack of social support. Coping with stress can be a leading cause in preventing psychological distress and a serious illness.

Methods

A correlational cross-sectional approach was applied to the current research. The research targeted all secondary school male students in Abha city. A multistage cluster sample was applied by selecting schools and students from the Directorate of Education in Abha. Self-administered questionnaire sheets were distributed to students in their classes. The questionnaire covered students' sociodemographic data such as age, grades, parents' education and work, living conditions, and comorbidities. Stressors to which the students were exposed were also enumerated with the degree of stress for each. Stress was assessed using the Holmes-Rahe Stress Inventory for youth. Coping skills were measured using the abbreviated version of the COPE Inventory.

Results

The study included 324 students whose ages ranged from 15 to 20 years old with a mean age of 17 ± 0.9 years old. Approximately 33% of the students were in first grade; 44.4% of the students had no or minimal level of stress while major stress was recorded among 26.5% of the students. In total, 77.8% of the students had moderate coping and none had high coping ability.

Conclusion

The study revealed that more than half of the students had significant levels of stress and one out of each four had major stress. The most common stressors were due to the school environment and future planning. Young age, low socioeconomic status, parents' separation, and having chronic health problems were the most important determinants of stress among the students.

Academic help-seeking behaviour and barriers among college nursing students

Background

First-year college student's smooth transition and academic success influenced by academic help-seeking behaviour. Academic help-seeking behaviour is largely affected by many factors, including demographic factors, self-esteem and the use of sources for academic learning.

Aim

The study investigated academic help-seeking behaviour and barriers among first-year college nursing students.

Setting

The study was conducted at a nursing college in the Western Cape province of South Africa.

Methods

A cross-sectional descriptive survey design with a self-administered questionnaire was used to collect data from 130 first year nursing college students. Descriptive statistics and bivariate analysis were computed using Statistical Packages for Social Sciences (SPSS).

Results

More than 77.7% used course materials and books to help with academic learning, 50% of students sought help from their teachers. Only 24.6% and 17.7% of students used YouTube and computers respectively. In all items measured help-seeking is not a threat to self-esteem, teachers and parents did not have unrealistic expectations of their academic performance. Language is significantly associated with (p < 0.001) academic help-seeking behaviour.

Conclusion

Most students mainly used informal sources for academic learning. Help-seeking was not a threat to self-esteem. The language barrier is significantly associated with academic help-seeking behaviour. The nursing college should provide a coordinated academic language support, academic consultation and counselling services for academically stressed first-year nursing students.

Contribution

The findings highlighted language as a barrier to academic help-seeking. The study provides insight to strengthen the language and academic support for academic learning for first year nursing students.

A Sense of Belonging and Help Seeking: Examining Factors Related to the Mental Health of High School Students with High Autistic Traits without Diagnosis

Certain individuals are clinically undiagnosed for Autism Spectrum Disorder (ASD) but exhibit strong ASD characteristics. This study examined the differences between a control group and a "high autistic traits" group involving individuals who scored 9 or higher on the Autism-Spectrum Quotient-16 Japanese Version, based on their sense of belonging, help-seeking style, and relationship with mental health. The participants were 608 Japanese public high school students. Of them, 129 (21.2%) and 479 (78.8%) were in the high autistic traits and control groups, respectively. A multiple regression analysis was performed using the General Health Questionnaire (GHQ) as the dependent variable for the groups. The analysis revealed no differences between the two groups regarding grade, gender, physical illness, insomnia, or mental health status; however, they differed regarding avoidant help-seeking style and teacher acceptance. Moreover, avoidant help-seeking scores in the high autistic traits group and teacher acceptance showed a significantly positive and significantly negative association with GHQ, respectively. The results indicated that children with autistic traits internally suppress them, experiencing distress. Teachers are aware that these students seek support from them, but the students seem reluctant to ask them for help. This can negatively impact the mental health of children with high autistic traits.

Validating the Arabic version of the Connor-Davidson resilience scale among university students

BACKGROUND

The Connor-Davidson Resilience Scale (CD-RISC) stands out as a widely used measure of psychological resilience. The original CD-RISC consists of 25 items, commonly referred to as CD-RISC-25.

AIM

This study aims to validate the Arabic version of the CD-RISC-25 involving a sample size of 1220 participants from three universities in Jordan.

METHODS

The researcher conducted a methodological investigation to examine the validation process. This included an examination of the translation process and an evaluation of content validity, which was assessed using the content validity index (CVI). Construct validity was assessed through exploratory factor analysis and confirmatory factor analysis, while convergent and discriminant validity were both evaluated using composite reliability (CR) and the square root of the average variance extracted.

RESULTS

Results showed a prominent level of psychological resilience 76.74±15.2 among the participating university students. Regarding the validity of the Arabic version of CD-RISC-25, the CVI yielded a value of 0.88, signifying a robust level of content validity. The analysis identified four constructs that accounted for 56.26% of the total variance. The goodness-of-fit indices, including goodness of fit index of 0.91, comparative fit index of 0.91, incremental fit index of 0.93, Tucker-Lewis index of 0.94, and root mean square error of approximation of 0.048, provided strong evidence supporting the alignment between the observed data and the hypothesized constructs. Discriminant and convergent validity were found to support the validity of the Arabic version of CD-RISC-25. Regarding the reliability, it demonstrated excellent reliability, with a total Cronbach's alpha of 0.934 and all CR values surpassing the threshold of 0.70, thereby further establishing its overall robustness.

CONCLUSION

The results provide substantial evidence for the validity and reliability of the translated Arabic CD-RISC-25.

Academic Burnout, Family Functionality, Perceived Social Support and Coping among Graduate Students during the COVID-19 Pandemic

Academic burnout and the COVID-19 pandemic have greatly impacted the academic life and mental health of graduate students. This study aims to address the mental health issue in graduate students by relating it to family functionality, perceived social support, and coping with academic burnout during the COVID-19 pandemic. Data were gathered from a cross-sectional study with 519 graduate students across universities in Hungary and other European countries. The Copenhagen Burnout Inventory Student, Family APGAR Index, the brief form of the Perceived Social Support Questionnaire, and the Brief Resilient Coping Scale were used to measure academic burnout, family functionality, perceived social support, and coping, respectively. Structural equations modeling was used for statistical analysis. The results revealed a negative effect of family functionality, perceived social support, and coping on academic burnout. The inverse relationship between perceived social support and the Copenhagen Burnout Inventory was identified, and mediated by coping and family functionality. These findings may offer patterns and predictors for future graduate students and higher-education institutions to identify outside factors that are implicated in academic burnout, especially in outbreaks such as the COVID-19 pandemic.

Association between Family and School Pressures, Consumption of Ultra-Processed Beverages, and Obesity in Preadolescents: A School-Based Epidemiological Study

The aim of the present work was two-fold. Firstly, to evaluate the association between the consumption of ultra-processed beverages (UPB) on preadolescents’ likelihood of being obese. Secondly, to investigate the potential impact of family and school environmental stressors on this unhealthy lifestyle habit. A cross-sectional study was conducted among 1718 Greek preadolescents and their parents, during the school years 2014 to 2016. Parental and child characteristics were collected anonymously, through self-administered and validated questionnaires. Among others, UPB consumption (soft and flavored drinks) was recorded, classifying children as low, moderate, or high consumers, while anthropometric characteristics [height, body weight, Body Mass Index (BMI)] were also recorded. Almost seven out of ten preadolescents were classified as at least moderate UPB consumers, while approximately three out of ten were classified as high UPB consumers. Higher UPB consumption was associated with significantly higher levels of BMI, while preadolescents living in a more stressful family and school environment were found to consume significantly higher amounts of UPB. Stakeholders should implement programs that raise awareness among parents and teachers about the sources of stress in preadolescence as a potential “triggering factor” of unhealthy dietary preferences.

Mental Health of Students at Polish Universities after Two Years of the Outbreak of COVID-19

BACKGROUND

Mental health deterioration in young adults in the aftermath of the COVID-19 pandemic is being increasingly studied. It is clear that the psychological consequences of the pandemic will be evident for many years, especially among the younger generation, who did not have time to acquire adaptive coping strategies before the outbreak of COVID-19. The purpose of this study was to assess the condition of the mental health of students at Polish universities after two years of the pandemic. The types of coping strategies used by the respondents to deal with stress were also evaluated in order to establish which of them could have a beneficial effect on the psyche of young people.

METHODS

This study included 721 participants (age [years]: M = 25.7, SD = 5.3; 269 (37.2%) males) recruited using snowball sampling from students at two universities in Lodz, Poland, and full-time doctoral students from across Poland (phase I of the study was conducted in March 2019 (N = 352); phase II of the study was conducted in April 2022 (N = 369)). The following tools were used in this study: The General Health Questionnaire (GHQ-28) by D. Goldberg, the Perceived Stress Scale (PSS-10), and the Inventory for Measuring Coping with Stress (Mini-COPE) by Carver et al. Pearson's chi-square test and multivariate logistic regression were used in the statistical analysis.

RESULTS

The results detailing the condition of the mental health of the subjects, as measured using GHQ-28, were significantly worse in the group surveyed after two years of the pandemic than the results of the survey conducted in March 2019 (adjusted odds ratio for GHQ-28 ≥ 5: 3.66, 95%CI 2.12-6.30, p < 0.001). Statistically significant differences were seen for each of the subscales of the GHQ-28 questionnaire. Most often, the subjects complained of anxiety symptoms and sleep disorders, in addition to somatic symptoms. The risk factors for worsening mental health included female (odds ratio 1.70, 95%CI 1.20-2.40, p = 0.003) and professional inactivity (odds ratio 1.55, 95%CI 1.04-2.31, p = 0.031). On the other hand, the ages of the people surveyed, their relationship status, whether they had children, or the type of university they attended all proved to be insignificant. The following coping strategies had a positive impact on the mental health of the respondents: positive reframing (Z = -2.951; p = 0.003) and seeking emotional support (Z = -2.351; p = 0.019). In contrast, strategies such as self-distraction (Z = 2.785; p = 0.005), denial (Z = 2.948; p = 0.003), venting (Z = 2.337; p = 0.019), self-blame (Z = 5.511; p < 0.001) and behavioral disengagement (Z = 4.004; p < 0.001) were associated with poorer mental health among the respondents.

CONCLUSIONS

1. Of the students surveyed, 33% reported elevated stress levels after two years of the COVID-19 pandemic. 2. The overall mental health of students at Polish universities, as measured by GHQ-28, was significantly worse in the group evaluated after two years of the COVID-19 pandemic, mainly in respect of anxiety symptoms and sleep disorders. 3. Female gender and professional inactivity appeared to be risk factors for the students' worsening mental health, which may be an indication of the need for further research and planning of psychotherapeutic interventions.