Perceived Academic Stress and Depression: The Mediation Role of Mobile Phone Addiction and Sleep Quality

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 mediating role of psychological capital on the relationship between perceived stress and self-directed learning ability in nursing students

BACKGROUND

As indispensable reserves for the nursing workforce, undergraduate nursing students must possess self-directed learning abilities to consistently update their professional knowledge and adapt to the evolving demands of professional development. The acquisition of self-directed learning abilities can help undergraduate nursing students augment their theoretical knowledge and refine their clinical practice skills, thus fulfilling the demand from patients for high-quality nursing services. Hence, comprehending and investigating the factors that influence the development of self-directed learning abilities in nursing students is of paramount importance for nursing education and advancement of the nursing profession.

OBJECTIVES

This study investigated the status of and associations between perceived stress, psychological capital, and self-directed learning abilities among undergraduate nursing students. Additionally, it examines the mediating role of psychological capital in the relationship between perceived stress and self-directed learning abilities. Thus, aiming to provide nursing educators with new directions for enhancing self-directed learning abilities.

DESIGN

A cross-sectional descriptive study.

METHODS

In February and March 2023, 900 undergraduate nursing students from 10 nursing schools completed an online questionnaire. The questionnaire included measures of perceived stress, psychological capital, and self-directed learning ability. Data were analyzed using SPSS 27.0 and the PROCESS macro tool.

RESULTS

The scores for perceived stress, psychological capital, and self-directed learning ability among undergraduate nursing students were 40.07 ± 5.90, 99.89 ± 16.59, and 87.12 ± 9.20, respectively. Self-directed learning abilities were negatively correlated with perceived stress (r = -0.415, p < 0.001) and positively correlated with psychological capital (r = 0.465, p < 0.001). Perceived stress was negatively correlated with psychological capital (r = -0.630, p < 0.001). Psychological capital partially mediated the relationship between perceived stress and self-directed learning abilities among undergraduate nursing students, with a mediation effect of -0.166, accounting for 49.55% of the total effect.

CONCLUSION

This study found that undergraduate nursing students perceived high levels of stress, possessed low levels of psychological capital, and had moderate levels of self-directed learning. Perceived stress and psychological capital directly influenced undergraduate nursing students' self-directed learning abilities, and perceived stress indirectly affected self-directed learning abilities through psychological capital. Nursing managers and educators should alleviate the perceived stress of undergraduate nursing students and cultivate their positive psychological capital to enhance self-directed learning abilities.

Associations of perceived stress with loneliness and depressive symptoms: the mediating role of sleep quality

BACKGROUND

Whether perceived stress is associated with loneliness and depressive symptoms in general adults, and to what extent sleep quality mediates the associations, remains unknown. The aim of this study was to estimate the associations of perceived stress with loneliness and depressive symptoms, and the mediating role of sleep quality in these associations.

METHODS

Cross-sectional data on 734 participants (aged 18-87 years) were analyzed. Perceived stress was assessed using the 10-item Perceived Stress Scale (PSS-10; range 0-40). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI; range 0-21). Loneliness was assessed using the three-item short form of the Revised University of California, Los Angeles (UCLA) loneliness scale (range 3-9). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression (CESD-10) Scale (range 0-30). General linear regression models, multivariable logistic regression models, and formal mediation analysis were performed.

RESULTS

After adjustment for age and sex, we found that with each 1-point increment in the perceived stress score, both the loneliness score (β = 0.07; 95% confidence interval [CI]: 0.06, 0.08) and depression score (β = 0.45; 95% CI: 0.40, 0.49) increased significantly. Robust results were observed when adjusting for more confounders. Furthermore, sleep quality mediated 5.3% (95% CI: 1.3%, 10.0%; P = 0.014) and 9.7% (95% CI: 6.2%, 14.0%; P < 0.001) of the associations of perceived stress score with loneliness score and depression score, respectively.

CONCLUSIONS

In general Chinese adults, perceived stress was positively associated with loneliness and depressive symptoms, and sleep quality partially mediated these associations. The findings reveal a potential pathway from perceived stress to mental health through sleep behaviors, and highlight the importance of implementing sleep intervention programs for promoting mental health among those who feel highly stressed.

How and when is academic stress associated with mobile phone addiction? The roles of psychological distress, peer alienation and rumination

BACKGROUND

Mobile phone addiction has a high detection rate among adolescents and is thought to be related to academic stress. However, the underlying mechanisms in this relation were still unclear. The present study tested the mediating role of psychological distress and the moderating roles of peer alienation and rumination in the relationship between academic stress and mobile phone addiction.

METHODS

A total of 742 middle school students were recruited to complete measures of academic stress, psychological distress, mobile phone addiction, peer alienation, rumination, and demographic variables. Regression-based statistical mediation and moderation were conducted using the PROCESS macro for SPSS.

RESULTS

The results indicated that academic stress was significantly and positively associated with mobile phone addiction, and this link could be mediated by psychological distress. Moreover, this indirect effect was moderated by both peer alienation and rumination. Specifically, the mediating effect of psychological distress was stronger for adolescents with higher levels of peer alienation or adolescents with higher levels of rumination, as well as those with both higher levels of peer alienation and rumination.

CONCLUSION

The findings of this study enrich our understanding of how and for whom academic stress is correlated with mobile phone addiction. Education experts and parents should pay special attention to adolescents suffering from academic stress, especially those with higher peer alienation and rumination, and help them get rid of mobile phone addiction.

The association between the deviation from balanced time perspective on adolescent pandemic mobile phone addiction: the moderating role of self-control and the mediating role of psychological distress

Background

Few studies have examined the impact that the deviation from balanced time perspective (DBTP) had on mobile phone addiction during the COVID-19 normalization prevention and control phase. Therefore, this study sought to determine the associations between DBTP, depression and anxiety, self-control, and adolescent mobile phone addiction.

Methods

The moderated mediating model was tested using the SPSS PROCESS model. The sample was 1,164 adolescents from different regional areas of Sichuan, China. From February to March 2020, participants completed the Zimbardo time perspective inventory (ZTPI), the brief symptom inventory for physical and mental health (BSI-18), the self-control scale (SCS), and the Chinese version of the mobile phone addiction index (MPAI).

Results

The DBTP was significantly and positively correlated with mobile phone addiction, depressive and anxiety symptoms mediated the relationship between DBTP and mobile phone addiction, self-control moderated the indirect effect of DBTP on mobile phone addiction, and as the level of self-control increased, the effect of DBTP on anxiety and depression and the effect of depression and anxiety on mobile phone addiction weakened.

Conclusion

During the COVID-19 pandemic, DBTP and lower self-control were risk factors for higher mobile phone addiction in adolescents. Therefore, guiding adolescents to balance their time perspective and enhance their self-control could strengthen their psychological well-being and reduce addictive mobile phone behaviors. This research was supported by "Youth Fund of the Ministry of Education" (18YJCZH233): "Research on the plastic mechanism of decision-making impulsiveness of anxious groups in the context of risk society."

Social media addiction relationship with academic engagement in university students: The mediator role of self-esteem, depression, and anxiety

This research analyzed how addiction to social media relates to academic engagement in university students, considering the mediating role of self-esteem, symptoms of depression, and anxiety. A quantitative methodology was used with a non-experimental-relational design. A set of questionnaires was applied to a non-probabilistic sample of 412 students enrolled at the National Autonomous University of Honduras. On average, participants use 4.83 different social media platforms at least once a week. Instagram and TikTok users report significantly higher levels of social media addiction, symptoms of depression, and anxiety compared to non-users. Directly, social media addiction does not significantly influence academic engagement scores. However, there are significant indirect inverse effects on academic engagement. Symptoms of depression and self-esteem mediate these effects. Social media addiction increases symptoms of depression, which in turn decreases academic engagement scores. Social media addiction decreases self-esteem, which serves as a variable that significantly increases academic engagement. Overall, findings suggest that social media addiction has a total inverse effect on academic engagement; symptoms of depression and self-esteem mediate this relationship. The implications of these findings are discussed.

The impact of problematic mobile phone use and the number of close friends on depression and anxiety symptoms among college students

Background

Psychological problems often occur in college students, with the most common ones being depression and anxiety symptoms. Exploring the risk factors that influence depression and anxiety symptoms in college students is essential to promote their physical and mental health.

Objective

This study aimed to investigate the independent and interaction effects of problematic mobile phone use (PMPU) and the number of close friends (NCFs) on depression and anxiety symptoms and the comorbidity of these symptoms among college students.

Methods

A cross-sectional survey was conducted in Huainan, Anhui Province, and Suzhou, Jiangsu Province in China from October to December 2022. Data from 7,617 college students were collected. The Patient Health Questionnaire and Generalized Anxiety Disorder-7 were used to evaluate depression and anxiety symptoms. The PMPU data were collected by the Mobile Phone Addiction Type Scale. Multinomial logistic regression models were performed to examine the associations of PMPU and NCFs with depression and anxiety symptoms and their interaction effects.

Results

PMPU and lack of close friends significantly increased the risk of depression and anxiety symptoms and the comorbidity of these symptoms in college students (p < 0.001). In addition, the effects of PMPU and lack of close friends on depression and anxiety symptoms in college students were interactive (p < 0.001). No significant sex differences were found.

Conclusion

PMPU and lack of close friends are important risk factors for depression, anxiety, and the comorbidity of these symptoms in college students in China.

Sleep disturbance and medical requests among university and college students in Chongqing, China: A cross-sectional study

OBJECTIVES

To investigate the prevalence of sleep disturbance, sleep patterns, sleep-related factors, and medical demands among university and college students in Chongqing, China.

METHODS

Demographic data and responses to the sleep problem questionnaire (SPQ) were collected from 1973 students from 11 universities and 10 colleges between November 2022 and January 2023.

RESULTS

The prevalence of sleep disturbance in university and college students was different in different periods (58.17% during campus lockdown and 40.30% after the lifting of lockdown). The combined prevalence was 49.72%. The prevalence of the 6 types of sleep disturbance showed the same trend. The average sleep latency was 32.79 minutes and the average sleep duration was 7.53 hours. Male, university students, upper-class students, history of depression, academic stress, major life events, bad bedroom environment, and campus lockdown were factors related to sleep disturbance among respondents. Most of the respondents (52.09%) had no medical care requests, and the major reasons were a lack of access to medical care (75.15%), economic pressure (68.49%), concerns regarding curative effects (58.51%), and academic pressure (56.56%).

CONCLUSION

The prevalence of sleep disturbance for university and college students was obviously improved after the lifting of campus lockdown, and the major factors related to sleep disturbance were study, life, mental health, and sleep environment. The students examined herein reported relatively low medical care requests when they experience sleep disturbance.

Absolute and relative preferences for mobile phone internet content, mobile phone dependence, and depressive symptoms: a study of Chinese university students in the post-pandemic era

Background

Due to the COVID-19 pandemic, Chinese university students may have increased mobile phone dependence, a habitual behavior in the student population and a risk factor for depressive symptoms. Therefore, this study explored the association between mobile phone dependence and depressive symptoms in Chinese university students in the post-pandemic era. It also investigated the effects of different types and categories of mobile phone Internet content preferences. In particular, this study examined whether mobile phone dependence mediates the relationship between absolute preference (AP) for mobile phone Internet content and depressive symptoms, and whether relative preference (RP) for mobile phone Internet content moderates the association between mobile phone dependence and depressive symptoms.

Methods

A cross-sectional study of Chinese university students recruited through Credamo was conducted in February-March, 2023. Participants completed the Mobile Phone Internet Content Preference Questionnaire, Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use, and Center for Epidemiological Survey, Depression Scale. Statistical analyses included descriptive statistics, correlation, regression, and analyses of mediation and moderation effects. The final sample comprised 1,602 students (709 males).

Results

We found a positive association between mobile phone dependence and depressive symptoms. The mediating role of mobile phone dependence between AP for mobile phone Internet content and depressive symptoms differed according to the type and category of content. Meanwhile, different types and categories of RP for mobile phone Internet content moderated the association between mobile phone dependence and depressive symptoms in opposite directions.

Conclusion

Our results highlight the interrelationships among mobile phone Internet content preferences, mobile phone dependence, and depressive symptoms in Chinese university students. For different types and categories of mobile phone Internet content preferences, we propose distinct preventive measures to alleviate students' depressive symptoms.

Mobile phone addiction and mental health: the roles of sleep quality and perceived social support

As a global phenomenon, mobile phone addiction has become an increasingly common issue among Chinese university students. Although previous research explored the link between mobile phone addiction and mental health, the possible mechanism underlying the above association is unclear. We administered a cross-sectional survey to 585 participants from two universities in Kunming, southwest China, from October 2021 to January 2022. Our results suggested that mobile phone addiction was negatively associated with mental health, and sleep quality partially mediated the relationship between mobile phone addiction and mental health. Furthermore, perceived social support positively moderated the direct effect of sleep quality on mental health, as well as the indirect effect of mobile phone addiction on mental health. These findings provide a new insight into the underlying mechanism by which mobile phone addiction affects university students' mental health. The results emphasize a necessary task for administrators, health workers, and family members to attach importance to the overuse of mobile phones among university students.

Associations between sleep characteristics, chronotype and body mass index among Chinese college freshmen

Research indicates that sleep problem is a behavioral risk factor of obesity. However, few research have applied a multi-dimensional approach to investigate the relationship between sleep health and adiposity. Therefore, the current study aimed to examine the associations of sleep characteristics (duration, quality) and chronotype with overweight/obesity as measured by body mass index. Data were obtained from 2014 college students from the Dali University in the Yunnan province of China in the year 2021. Sleep characteristics and chronotype were measured using self-reported questionnaires. The presence of overweight/obesity was assessed by anthropometric measurements. Multiple logistic regression models and restricted cubic spline hazard models were established to examine associations between sleep characteristics, chronotype and adiposity. After adjusting for demographic characteristics and other obesity-related behavioral risk factors, evening type was positively associated with overweight/obesity, and an L-shaped dose-effect relationship was observed between chronotype scores and the presence of overweight/obesity. However, sleep duration and quality were not associated with the presence of overweight/obesity in the logistic regression models and restrictive cubic splines models. This study indicated that Chinese college students who had the evening chronotype were more likely to be affected by overweight/obesity. Chronotype as an important dimension of sleep health should be incorporated in obesity intervention programs.

Gender-based differences in interaction effects between childhood maltreatment and problematic mobile phone use on college students' depression and anxiety symptoms

BACKGROUND

Childhood maltreatment and problematic mobile phone use are risk factors for depression and anxiety symptoms among college students. However, how the interaction between the two factors affects depression and anxiety has yet to be validated. This study aimed to investigate the independent and interaction effects of childhood maltreatment and problematic mobile phone use on depression and anxiety among college students and explored gender-based differences in these associations.

METHOD

A cross-sectional study was conducted from October to December 2019. We collected data from 7623 students at two colleges in Hefei and Anqing cities in Anhui Province, China. Multinomial logistic regression models were performed to explore the associations of childhood maltreatment and problematic mobile phone use with depression and anxiety symptoms and their interaction effects on depression and anxiety symptoms.

RESULTS

Childhood maltreatment and problematic mobile phone use were significantly associated with increased risk of depression and anxiety symptoms (P < 0.001). Moreover, following adjustments for covariates, there was a multiplicative interaction between childhood maltreatment and problematic mobile phone use on depression and anxiety symptoms (P < 0.001). Gender-based differences were also observed in the associations. For instance, depression was more common in males and male students with childhood maltreatment were at higher risk of depression-only symptoms.

CONCLUSION

Focusing on childhood maltreatment and problematic mobile phone use could facilitate a reduction in the occurrence of depression and anxiety symptoms in college students. Furthermore, it is necessary to develop gender-targeted intervention strategies.

A comprehensive review on emerging trends in the dynamic evolution of digital addiction and depression

Introduction

Using digital addiction as an umbrella term to cover any type of addictions to digital technologies such as the internet, smartphones, social media, or video games, the current study aimed to reveal the intellectual structure and evolution of research addressing digital addiction-depression relationship.

Methods

The study combined bibliometric and science mapping analysis methods for this purpose. Data for the study was gathered from Web of Science Core Collection after a comprehensive process of data search/extraction, and 241 articles were included in the final data set. A period-based, comparative science mapping analysis was performed using the SciMAT software.

Results

The analysis of data over three periods, Period 1 (1983-2016), Period 2 (2017-2019), and Period 3 (2020-2022) showed that internet addiction was the most significant theme across all three periods, which was followed by social media addiction. Depression, which emerged as a significant theme during Period 1, was later covered under anxiety disorder theme. Research interest was mostly on factors related to both addiction and depression such as cognitive distortion, insomnia, loneliness, self-esteem, social support, alexithymia, as well as cybervictimization or academic performance.

Discussion

The results suggested that much research is warranted on the digital addiction-depression relationship in different age cohorts, especially children and elderly. Similarly, the current analysis showed that this line of research particularly focused on internet, gaming and social media addiction, and evidence with regard to other types of digital addiction or related compulsive behaviors was almost absent. In addition, research was mostly inclined to understanding cause-effect relationships, which is significant, but preventive strategies seemed to be barely addressed. Likewise, the smartphone addiction-depression relationship arguably garnered less research interest, so future research would contribute to the field in this respect.

Meaning in life and smartphone addiction among Chinese female college students: The mediating role of school adjustment and the moderating role of grade

Background

The fact that female college students are more addicted to smartphones than male college students has raised public concerns. However, previous studies have rarely explored the mechanism of female college students' smartphone addiction. Previous studies have shown that identity may affect the formation process of female college students' smartphone addiction, and the identity of female college students in different grades may be different. Nonetheless, few studies have explored the grade differences in the formation process of female college students' smartphone addiction.

Methods

The present study examined the relationship between meaning in life, school adjustment, and smartphone addiction among Chinese female college students using a moderated mediation model in which school adjustment played a mediating role and grade played a moderating role. A total of 1,076 Chinese female college students (Age: 19.83 ± 1.11; 369 freshmen, 379 sophomores, and 328 juniors) completed an online questionnaire regarding meaning in life, school adjustment, and smartphone addiction.

Results

(1) School adjustment mediated the relationship between meaning in life and smartphone addiction. (2) School adjustment had a partial mediating effect between meaning in life and smartphone addiction for female freshmen and sophomores, but it did not exist among female juniors. (3) The influence of school adjustment on female sophomores' smartphone addiction was significantly stronger than that of female freshmen.

Conclusion

The findings of this study advance our understanding of the potential impacts of meaning in life on smartphone addiction and provide a grade perspective for targeted prevention or intervention with female college students' smartphone addiction.

Effects of interpersonal sensitivity on depressive symptoms in postgraduate students during the COVID-19 pandemic: Psychological capital and sleep quality as mediators

Background

This study aimed to examine depressive symptoms associated with interpersonal sensitivity, sleep quality, and psychological capital among postgraduate students during static campus management after the COVID-19 pandemic in China.

Methods

Research data were obtained during static campus management (10-19 April 2022) after the reappearance of COVID-19 in cities in eastern China. We collected data through an online questionnaire, and the anonymous self-reported questionnaire included the Patient Health Questionnaire, the interpersonal sensitivity subscale of Symptom Checklist-90, the Psychological Capital Questionnaire, and the Pittsburgh Sleep Quality Index. analysis of variance was performed using t-test and ANOVA. The PROCESS macro was used to determine the relationship between interpersonal sensitivity and depression, together with the independent and serial mediating role of psychological capital and sleep quality.

Results

A total of 2,554 postgraduate students were included in this study. The prevalence of mild, moderate, and severe depressive symptoms was 30.97, 6.58, and 1.45%, respectively. Interpersonal sensitivity was significantly associated with depressive symptoms (direct effect = 0.183, p < 0.001). Between interpersonal sensitivity and depressive symptoms, psychological capital and sleep quality played a single mediating role (indirect effect = 0.136 and 0.100, p < 0.001, respectively) and a chain mediating role together (indirect effect = 0.066, p < 0.001).

Conclusion

Interpersonal sensitivity has a significant influence on depression among Chinese graduate students. Psychological capital and sleep quality may not only independently mediate the relationship between interpersonal sensitivity and depression, but also co-play a chain-mediating role in the pathway from interpersonal sensitivity to depression. Positive psychological interventions and sleep guidance may be beneficial in alleviating depressive symptoms.

Interpersonal sensitivity on college freshmen's depression: A moderated moderation model of psychological capital and family support

BACKGROUND

The prevalence of depressive symptoms has become very high among college freshmen, with interpersonal sensitivity serving as an important predictor of depression. Combining internal and external positive resources can effectively prevent and alleviate depression. This study explores the moderating role of psychological capital (PsyCap) in the relationship between interpersonal sensitivity and depression, as well as the moderating effect of familial support on the conditional influence of PsyCap among Chinese college freshmen.

METHODS

A cross-sectional mental health survey was performed and the anonymous self-reported questionnaires, including the Patient Health Questionnaire, interpersonal sensitivity subscale of Symptom Checklist-90, Psychological Capital Questionnaire 24, and Perceived Social Support from Family, were distributed to the freshmen. Pearson's coefficient was employed to describe correlations between variables. The PROCESS macro and slope difference tests were used to explore the moderating role of PsyCap and family support in the relationship between interpersonal sensitivity and depression.

RESULTS

The prevalence of depression among freshmen was 30.89% (694/2,247). The correlation analysis revealed that depression negatively related to PsyCap (r = -0.187, p < 0.001) and family support (r = -0.193, p < 0.001) and positively related to interpersonal sensitivity (r = 0.399, p < 0.001). The moderation analysis showed that PsyCap negatively moderated the positive relationship between interpersonal sensitivity and depression (β = -0.159, p < 0.001). We also found that family support played a moderating role in the conditional influence of PsyCap (β = 0.076, p < 0.01). The slope difference test further showed that family support weakened the effect of interpersonal sensitivity on depression in freshmen when they had low PsyCap.

CONCLUSION

More attention should be paid to freshmen's mental health and interpersonal interaction problems. For freshmen with interpersonal sensitivity and depression, mental health departments can conduct PsyCap development interventions to alleviate psychological symptoms. Freshmen themselves should also seek family support in time, but those individuals with high PsyCap should seek an appropriate level of family support to maintain their autonomy.