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Huang Y, Yang L, Liu Y, Zhang S. Effects of perceived stress on college students' sleep quality: a moderated chain mediation model. BMC Psychol 2024; 12:476. [PMID: 39252073 PMCID: PMC11385478 DOI: 10.1186/s40359-024-01976-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 09/02/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Perceived Stress has been shown as a key contributor to sleep quality, but the underlying mechanism between perceived stress and sleep quality remains unknown. This study aimed to investigate the impact of perceived stress on sleep quality of college students and the chain mediating roles of presence of meaning in life (PML) and depression, as well as the moderating role of search for meaning in life (SML). METHODS Participants were 8178 college students (4599 boys and 3579 girls; Mage = 19.10 years, SD = 1.08) who completed self-report questionnaire, including the Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), the Meaning in Life Questionnaire (MLQ), and the Patient Health Questionnaire-9 (PHQ-9). RESULTS The results showed that higher perceived stress was directly related to poorer sleep quality. This negative impact on sleep quality was mediated through the chained roles of PML and depression. Additionally, the study found that SML moderates the influence of perceived stress, PML and depression on sleep quality. Specifically, for individuals actively search for meaning, the adverse effects of perceived stress and depression on sleep quality are diminished. Concurrently, the positive influence of PML on sleep quality is enhanced. CONCLUSION This study revealed that the PML and depression mediate the effect of perceived stress on sleep quality, with SML playing a significant protective role. These results emphasize the necessity of integrating strategies to enhance PML and SML into interventions designed to improve emotion management and sleep quality among college students.
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Affiliation(s)
- Yaqing Huang
- Faculty of Education, Guangxi Normal University, Guilin, Guangxi, 541004, China
| | - Lei Yang
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, Hebei, 063210, China
- Hunan urban professional college, Changsha, Hunan, 410137, China
| | - Yang Liu
- School of Marxism, Beibu Gulf University, Qinzhou, Guangxi, 535011, China
| | - Shuyue Zhang
- Faculty of Education, Guangxi Normal University, Guilin, Guangxi, 541004, China.
- Department of Psychology, Faculty of Education, Guangxi Normal University, Guilin, Guangxi, 541004, China.
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Zila-Velasque JP, Grados-Espinoza P, Chuquineyra BSC, Diaz-Vargas M, Sierra Calderón GS, Choquegonza S, Temoche-Rivas MS, Siguas Peixoto K, Valladares-Garrido MJ, Failoc-Rojas VE. Resilience, sleep quality and sleepiness in Peruvian medical students: a multicenter study. Front Psychiatry 2024; 15:1284716. [PMID: 39211539 PMCID: PMC11358107 DOI: 10.3389/fpsyt.2024.1284716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 07/08/2024] [Indexed: 09/04/2024] Open
Abstract
Background Resilience can mitigate the negative impact produced by the COVID-19 pandemic. Medical students endure significant academic stress, so adjusting to sudden changes can present greater mental health challenges. The aim is to identify the level and prevalence of resilience and to know what are the educational variables and is sleep quality associated with resilience. Methods A cross-sectional study was conducted using an online questionnaire. The survey was elaborated in Google Forms and shared through social networks. The outcome was resilience, measured with the Connor Davidson Resilience Scale. Its association was assessed with sleep quality (measured with the Pittsburgh Sleep Quality Index), daytime sleepiness (measured with the Epworth Sleepiness Scale), and selected academic/sociodemographic variables. Generalized linear models were used to identify the association between the variables. Results Of 1277 participants, 35.7% experienced high resilience. Poor sleep quality and sleepiness were present in 88.4% and 36.0% of students, respectively. High resilience was associated with good sleep quality (PR:1.56; 95%CI: 1.34 - 1.83; p-value<0.001), absent sleepiness (PR:1.59; 95%CI: 1.32-1.91; p-value<0.001), male sex (PR: 1.21; 95%CI: 1.05-1.39; p-value 0.006), working (PR:1.14), having family responsibilities (PR: 1.36; 95%CI: 1.09-1.70; p-value 0.005) and spending more than 6 hours studying (PR: 1.35; 95%CI: 1.17-1.54; p-value<0.001). Conclusion 4 out of 10 students presented high levels of resilience. The development of resilience depended on multiple individual and sociodemographic factors. These findings are important to support universities in developing resilience-building measures and strategies that can be implemented to mitigate the adverse pandemic event.
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Affiliation(s)
| | | | | | - Mills Diaz-Vargas
- Facultad de Medicina Humana, Universidad Nacional del Centro del Peru, Huancayo, Peru
| | | | | | | | - Karina Siguas Peixoto
- Facultad de Medicina “Rafael Donayre Rojas”, Universidad Nacional de la Amazonía Peruana, Iquitos, Peru
| | - Mario J. Valladares-Garrido
- Facultad de Medicina, Universidad Continental, Lima, Peru
- Servicio de Epidemiología, Hospital Regional Lambayeque, Lambayeque, Peru
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Goodman ML, Lee M, Springer A, Schick V, Vaughan E, Markham C, Gitari S, Mukiri F. Sleep disturbance as a precursor to anxiety, depression, and PTSD among rural Kenyans: A cross-lagged panel analysis from a rural Kenyan interventional cohort. J Sleep Res 2024; 33:e14119. [PMID: 38083983 PMCID: PMC11164828 DOI: 10.1111/jsr.14119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/06/2023] [Accepted: 11/22/2023] [Indexed: 05/01/2024]
Abstract
Sleep quality is essential to biopsychosocial functioning, yet there remains limited longitudinal research on sleep and mental or social well-being within low- or middle-income countries. This study utilised longitudinal cohort data from a community-based empowerment programme in Meru County, Kenya to assess cross-lagged correlations between sleep disturbance, social support, symptoms of depression, anxiety, and posttraumatic stress. Participants (n = 373; 92% women; age range 18-86 years) who reported more sleep disturbance at T1 reported significantly more symptoms of depression, anxiety, and PTSD, and significantly less social support at T2 (average 11 weeks later), controlling for all within-time correlations across measures, within-measure correlations across time, and sociodemographic background characteristics. The findings are consistent with research across high-income countries, underscoring the need for more contextualised research into sleep behaviours across low- and middle-income countries. The findings may inform interventions to increase mental and social well-being within Kenya.
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Affiliation(s)
| | - Miryoung Lee
- University of Texas School of Public Health in Houston, TX, USA
| | - Andrew Springer
- University of Texas School of Public Health in Houston, TX, USA
| | - Vanessa Schick
- University of Texas School of Public Health in Houston, TX, USA
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Baattaiah BA, Alharbi MD, Aldhahi MI, Khan F. Factors associated with postpartum fatigue: an exploration of the moderating role of resilience. Front Public Health 2024; 12:1394380. [PMID: 38947349 PMCID: PMC11211369 DOI: 10.3389/fpubh.2024.1394380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/04/2024] [Indexed: 07/02/2024] Open
Abstract
Background Postpartum fatigue (PPF) can impair the physical and mental well-being of women. The aims of this study were to assess the associations between fatigue and maternal health-related variables, specifically, sleep quality, depression symptoms, and resilience, and to explore the moderating role of resilience in the relationships between sleep quality, depression symptoms, and fatigue. Methods This cross-sectional study used data collected from mothers during the postpartum period via an online platform. PPF was assessed using the Fatigue Severity Scale, whereas sleep quality and depression symptoms were assessed using the Pittsburgh Sleep Quality Index and Edinburgh Postnatal Depression Scale, respectively. The Brief Resilience Scale was used to assess resilience. Simple and multiple binary logistic regression analyses were performed to examine the association of each independent variable with PPF and to determine the most significant predictors of PFF. The data were analyzed using SPSS, and structural equation modeling was performed using AMOS 23. A moderation analysis was performed to explore the moderating role of resilience using the Hayes PROCESS macro. Results A total of 1,443 postpartum mothers were included in the analysis. The simple binary logistic regression analysis showed that having chronic disease (odds: 1.52; p = 0.02), mother's age (odds: 0.97; p = 0.03), mother's body mass index (BMI; odds: 1.03; p = 0.01), depression symptoms (odds: 1.09; p ≤ 0.0001), sleep quality (odds: 1.17; p ≤ 0.0001), and resilience (odds: 0.42; p ≤ 0.0001) all contributed to fatigue during postpartum. Multivariate logistic regression showed that the mother's BMI, sleep quality, depression symptoms, and resilience were significant predictors of PPF. Moderation analyses showed that resilience was not a significant moderator between the main effects of sleep quality and fatigue (interaction effect: β = 0.01, p = 0.31, 95% CI: -0.01 to 0.04) or between the main effects of depression symptoms and fatigue during postpartum (interaction effect: β = 0.01, p = 0.82, 95% CI: -0.01 to 0.02). Conclusion Given the deleterious effects of PPF on maternal health outcomes, factors associated with PPF should be assessed regularly. In addition to mothers' BMI, sleep quality, and depression symptoms, resilience could also be a crucial factor in predicting fatigue severity during this critical time for mothers even though it was not a significant moderator among this sample.
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Affiliation(s)
- Baian A. Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mutasim D. Alharbi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fayaz Khan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Zengin H, Soyaslan BD. Stress and sleep quality in palliative care. BMJ Support Palliat Care 2024:spcare-2024-004897. [PMID: 38862184 DOI: 10.1136/spcare-2024-004897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/28/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVES Palliative care patients experience problems in sleep quality due to stress, chronic diseases, and physical and psychosocial problems. Our aim is to determine the perceived stress and sleep quality levels of our palliative care patients and their related factors. METHODS This cross-sectional, descriptive research was conducted between November 2023 and February 2024 at a palliative clinic located in Ankara, Turkey, that is affiliated with a training and research hospital. In the research, a data form, the Perceived Stress Scale and the Pittsburgh Sleep Quality Index were used as data collection instruments. Kolmogorov-Smirnov and Shapiro-Wilk tests, and Mann-Whitney U and Kruskal-Wallis H tests were used for the analysis. RESULTS The total score on the Perceived Stress Scale was determined to be 35.81±7.45. The total score for Pittsburgh Sleep Quality Index was 13.20±3.20. Significant relationships were found between insufficient self-efficacy scores and habitual sleep efficiency, daytime dysfunction and total Pittsburgh Sleep Quality Index scores. Significant relationships were found between insufficient self-efficacy scores and sleep latency, habitual sleep efficiency, daytime dysfunction and total Pittsburgh Sleep Quality Index scores. CONCLUSIONS This study determined that certain descriptive characteristics of palliative care patients affect their sleep quality and perceived stress level, as well as that some components of sleep quality and perceived stress level are related. Palliative care is holistic in nature, encompassing symptom management; therefore, the importance of patients' psychosocial integrity should not be overlooked. Consequently, identifying components that may hinder symptom management and addressing the patient comprehensively will be crucial.
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Affiliation(s)
- Hilal Zengin
- Palliative care, Ministry of Health Ankara Gülhane Training and Research Hospital, Ankara, Etlik, Turkey
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Robinson LA, Short PR, Frugé AD. Sleep Quality and Interoception Are Associated with Generalized Anxiety in Baccalaureate Nursing Students: A Cross-Sectional Study. NURSING REPORTS 2024; 14:1184-1192. [PMID: 38804423 PMCID: PMC11130938 DOI: 10.3390/nursrep14020090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024] Open
Abstract
Baccalaureate nursing students are at increased risk for anxiety and related mood disorders. We conducted a cross-sectional study to explore the relationships among anxiety symptoms measured by the Generalized Anxiety Disorder (GAD-7) questionnaire and lifestyle behaviors including habitual diet, sleep quality (Pittsburg Sleep Quality Index [PSQI]), and physical activity. Descriptive statistics were obtained for sample characteristics, and Pearson correlations and backward stepwise linear regression explored relationships between the GAD-7 scores, the Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2) subscales, and other variables. Sixty-eight students completed the survey, with 38% having moderate-to-severe anxiety. On average, respondents had moderate diet quality (Healthy Eating Index median 60/100 [range 51-75]), had high sleep quality (PSQI median 7/21 [range 4-10]), and were highly active, with a median of 43 (range 24-78) weekly metabolic equivalent (MET) hours. Sixty-seven out of 68 respondents indicated a willingness to change lifestyle behaviors; the most prevalent time-related factors were school and social commitments, with stress and financial constraints being reported among half or more of respondents. Regression analysis determined that PSQI (β = 0.446) and the MAIA-2 Not-Worrying subscale (β = -0.366) were significant (p < 0.001 for both) predictors of anxiety severity. These results indicate that mindfulness and sleep hygiene may be the most actionable foci for interventions to reduce anxiety in baccalaureate nursing students. This study was not registered as a clinical trial.
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Affiliation(s)
- Laura A. Robinson
- Department of Nutritional Science, Auburn University, Auburn, AL 36849, USA
- College of Nursing, Auburn University, Auburn, AL 36849, USA
| | - Pamela R. Short
- College of Nursing, Auburn University, Auburn, AL 36849, USA
| | - Andrew D. Frugé
- College of Nursing, Auburn University, Auburn, AL 36849, USA
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Liu F, Liang W, Li H, Li Y, Zhang Y, Ding L, Zhang Q, Chen L. What can we learn about stress and sleep from COVID-19 pandemic-perspective from the theory of preventive stress management. Front Public Health 2024; 12:1383966. [PMID: 38638466 PMCID: PMC11024324 DOI: 10.3389/fpubh.2024.1383966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
Background The COVID-19 pandemic has presented unique challenges to individuals worldwide, with a significant focus on the impact on sleep. However, the precise mechanisms through which emotional and cognitive variables mediate this relationship remain unclear. To expand our comprehensive understanding of variables, the present study utilizes the Preventive Stress Management theory, to test the relationship between perceived social support and sleep quality, as well as the effect of perceived COVID-19 stress, hope, negative emotions and coping styles. Methods Data were collected in March 2022 from 1,034 college students in two universities located in Liaoning Province, China, using an online survey platform regarding perceived social support, perceived COVID-19 stress, sleep quality, hope, negative emotions and coping styles. The moderated mediation model were conducted using Process macro program (Model 6) and the syntax in SPSS. Results The results revealed perceived COVID-19 stress and negative emotions sequentially mediated the negative relationship between perceived social support and sleep quality. Furthermore, hope and coping styles were found to moderate the sequential mediating effect. Conclusion The present study sheds light on the pathways that affect sleep quality among college students during the COVID-19 pandemic. Findings highlight the protective roles played by positive social and personal resources, such as perceived social support, hope, and effective coping styles, against sleep problems. These insights have important implications for the development of targeted interventions to improve sleep outcomes during this challenging time.
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Affiliation(s)
- Fang Liu
- College of Teacher Education, Ningbo University, Ningbo, Zhejiang, China
| | - Weijie Liang
- College of Teacher Education, Ningbo University, Ningbo, Zhejiang, China
| | - Hanqi Li
- College of Teacher Education, Ningbo University, Ningbo, Zhejiang, China
| | - Yuyang Li
- College of Teacher Education, Ningbo University, Ningbo, Zhejiang, China
| | - Yue Zhang
- College of Teacher Education, Ningbo University, Ningbo, Zhejiang, China
| | - Lei Ding
- College of Teacher Education, Ningbo University, Ningbo, Zhejiang, China
| | - Qianqian Zhang
- College of Teacher Education, Ningbo University, Ningbo, Zhejiang, China
| | - Liang Chen
- Research Center for Psychological Development, University of Science and Technology Liaoning, Anshan, Liaoning, China
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Dial LA, DeNardo FA, Fevrier B, Morgan AL, Du C, Tucker RM, Hsiao PY, Ludy MJ. Comparing mental health and well-being of US undergraduate and graduate students during the early stages of the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2775-2785. [PMID: 34788587 DOI: 10.1080/07448481.2021.1996372] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 08/31/2021] [Accepted: 10/17/2021] [Indexed: 06/13/2023]
Abstract
Objective: This study explored how COVID-related mental health and well-being varied between undergraduate and graduate students. Relationships with physical health behaviors were also examined. Participants: Undergraduate (n = 897) and graduate (n = 314) students were recruited from three US universities between mid-April and late-May 2020. Methods: Participants in this cross-sectional survey self-reported perceived stress, financial stress, resilience, repetitive negative thinking, mood, anxiety, diet, sleep, and physical activity using validated instruments. Results: Undergraduate students reported more perceived stress, more repetitive negative thinking, less positive mood, and less support from professors than graduate students. Perceived stress, repetitive negative thinking, negative mood, and anxiety increased among all students (p < .05 for all). Correlations between mental health outcomes and physical health behaviors were weak to moderate (r = .08 to .49). Conclusions: College students, particularly undergraduates, perceived negative mental health impacts during COVID. Creative approaches for meeting student needs are necessary.
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Affiliation(s)
- Lauren A Dial
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
- Department of Psychology, California State University, Fresno, California, USA
| | - Faith A DeNardo
- Division of Health and Wellness, Bowling Green State University, Bowling Green, Ohio, USA
| | - Bradley Fevrier
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, Ohio, USA
| | - Amy L Morgan
- School of Human Movement, Sport, and Leisure Studies, Bowling Green State University, Bowling Green, Ohio, USA
| | - Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan, USA
| | - Robin M Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan, USA
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, Pennsylvania, USA
| | - Mary-Jon Ludy
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, Ohio, USA
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Li S, Wang X, Wang M, Jiang Y, Mai Q, Wu J, Ye Z. Association between stigma and sleep quality in patients with breast cancer: A latent profile and mediation analysis. Eur J Oncol Nurs 2023; 67:102453. [PMID: 37951070 DOI: 10.1016/j.ejon.2023.102453] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE This study aims to identify the heterogeneity in the stigma experienced by patients with breast cancer and examine the mediation effect of resilience on the relation between stigma and sleep quality. METHOD A total of 396 patients with breast cancer were enrolled from Be Resilient to Breast Cancer (BRBC) program between January and April 2023. Participants completed the Social Impact Scale, the 10-item Connor-Davidson Resilience Scale, and the Pittsburgh Sleep Quality Index Scale. Latent profile analysis (LPA) and mediation analysis were conducted to analyze the data. RESULTS LPA categorized stigma into three subgroups, namely low-stigma (21.9%), moderate-stigma (64.9%), and high-stigma (13.2%). Mediation analysis revealed a fully mediated effect in the comparison between low-stigma and moderate-stigma groups (standard error [SE] = 0.13, 95%CI = 0.06,0.56), whereas a partially mediated effect was observed in the comparison between low-stigma and high-stigma groups (SE = 0.18, 95%CI = 0.39,1.10). CONCLUSIONS Stigma is a significant factor to sleep quality in breast cancer and resilience could act as a robust buffer against stigma resulting in improved sleep quality. Resilience-based interventions might be helpful in this population.
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Affiliation(s)
- Shuhan Li
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xinqin Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Minyi Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Yingting Jiang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Qingxin Mai
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Jiahua Wu
- Department of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
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Candia CD, Miranda CR, Durán-Agüero S, Johns PC, Díaz-Vásquez W. Association between diet, mental health and sleep quality in university students during the COVID-19 pandemic: a systematic review. Int J Adolesc Med Health 2023; 35:429-436. [PMID: 38102886 DOI: 10.1515/ijamh-2023-0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/03/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES To evaluate recently published scientific evidence and synthesize the results of observational studies that examine the association between diet, mental health, and sleep quality in university students during the COVID-19 pandemic. CONTENT An electronic search of scientific literature published in 2021 and up to 2 years ago was performed using keyword search, with focus on observational studies published in PubMed, MEDLINE and Web of Science. It included: active university students of both sexes during the COVID-19 pandemic. SUMMARY AND OUTLOOK The 5 studies included in this review showed that there have been significant changes in both mental health and eating habits during the COVID-19 pandemic. The conclusion, there is an association between mental health and sleep quality in university students, resulting in an alteration of sleep hours and poor sleep. Furthermore, an association between mental health and diet quality is also observed, producing an increase in caloric intake or in the number of meals during the day.
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Affiliation(s)
- Constanza Díaz Candia
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Lota, Chile
| | - Camila Risco Miranda
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Lota, Chile
| | - Samuel Durán-Agüero
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Lota, Chile
| | - Priscila Candia Johns
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Lota, Chile
| | - Waldo Díaz-Vásquez
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Lota, Chile
- Molecular Microbiology and Food Research Laboratory, Universidad San Sebastián, Santiago, Chile
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Zhao R, Peng J, Li JY, Qin LL, Luo BA. Psychological Resilience of Chinese College Students: A Cross-Sectional Study after the Deblocking of China's COVID-19 Pandemic Strategy. Healthcare (Basel) 2023; 11:2409. [PMID: 37685441 PMCID: PMC10486725 DOI: 10.3390/healthcare11172409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/27/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
Psychological resilience (PR) plays an important role in fortifying mental health during pandemics. This study aimed to examine the PR and its related factors of college students in China after the deblocking of the China's COVID-19 pandemic strategy. A total of 1100 college students from 15 universities participated in this cross-sectional survey by multi-stage stratified sampling. Data were collected by self-designed socio-demographic information, the family function assessment scale (APGAR), a general health questionnaire (GHQ-12), the general self-efficacy scale (GSES), and a psychological resilience scale. The average score of PR was 135.65 ± 18.54. Cluster analysis of PR scores showed that 24.9% of the college students had weak PR. The higher PR, the higher mental health status (r = 0.352, p < 0.05). Females had higher PR than males (OR = 0.550, 95% CI: 0.367-0.827). High self-efficacy was an independent protective factor of high PR (OR = 0.093, 95% CI: 0.059-0.145). Low family contact frequency, poor family function, and bad mental health status were the independent risk factors of high PR. In conclusion, the PR of Chinese college students were insufficient after the deblocking of China's COVID-19 pandemic strategy, indicating an improvement of PR should be put into practice immediately. Frequent monthly contact with family, family function, self-efficacy, mental health status, and gender were the influencing factors of PR, which provides an intervention strategy for the future.
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Affiliation(s)
- Rong Zhao
- Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha 410007, China
| | - Jin Peng
- School of Medicine, Hunan Normal University, Changsha 410013, China
| | - Jia-Yin Li
- School of Medicine, Hunan Normal University, Changsha 410013, China
| | - Lu-Lu Qin
- School of Medicine, Hunan Normal University, Changsha 410013, China
| | - Bang-An Luo
- Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha 410007, China
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Abukhalaf AHI, Naser AY, Cohen SL, von Meding J, Abusal DM. Evaluating the mental health of international students in the U.S. during the COVID-19 outbreak: The case of University of Florida. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 36749870 DOI: 10.1080/07448481.2023.2168547] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/18/2022] [Accepted: 01/08/2023] [Indexed: 06/18/2023]
Abstract
Objective: The study aims to capture the emotional challenges faced by international students due to the changes in U.S. visa regulations during the COVID-19 outbreak. Participants: 165 international students from University of Florida participated in the study. Methods: We conducted a cross-sectional online survey using previously validated questionnaire tools (PHQ-9 and GAD-7). The collected data was quantitatively analyzed through different statistical approaches, including ANOVA, Independent Sample t-Test, and Binary Logistic Regression. Results: 18.8% of our study sample had a moderately severe to severe depressive status, and 20.6% of the study sample had severe anxiety. Additionally, there was a statistically significant difference in the depression and anxiety scores based on gender. Conclusions: Our findings addressed the importance of taking serious measures when emotionally impactful political issues arise to prevent the development of mental illnesses among international students at U.S. institutions of higher education.
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Affiliation(s)
- Amer Hamad Issa Abukhalaf
- Florida Institute for Built Environment Resilience, University of Florida, Gainesville, Florida, USA
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | | | - Jason von Meding
- Florida Institute for Built Environment Resilience, University of Florida, Gainesville, Florida, USA
| | - Deyaaldeen M Abusal
- Environmental Science of Engineering Department, University of Texas at El Paso, El Paso, Texas, USA
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13
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Chang X, Guo C, Zhou H, Liu L. Impact of rumination on sleep quality among patients with non‑alcoholic fatty liver disease: a moderated mediation model of anxiety symptoms and resilience. BMC Psychiatry 2023; 23:84. [PMID: 36732707 PMCID: PMC9893673 DOI: 10.1186/s12888-023-04572-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Poor sleep raises the risk of non-alcoholic fatty liver disease (NAFLD) and hastens disease progression. It is critical to figure out what factors impact the sleep quality of NAFLD patients. The present study aimed to investigate the role of anxiety symptoms in accounting for the impact of rumination on sleep quality and the moderating role of resilience on the associations of rumination with anxiety symptoms and sleep quality. METHODS In the cross-sectional study, 285 NAFLD patients completed the Chinese version of the Pittsburgh Sleep Quality Index, the Ruminative Responses Scale, the Generalized Anxiety Disorder 7-item scale, and the 14-item Resilience Scale to measure sleep quality, rumination (including brooding and reflection), anxiety symptoms, and resilience, respectively. The PROCESS macro for SPSS v4.0 procedure was applied to perform moderated mediation analysis. RESULTS The roles of anxiety symptoms in accounting for the positive associations of brooding, reflection and rumination with poor sleep quality were revealed. It was found that there was a significant moderating role of resilience on the positive associations of brooding, reflection and rumination with anxiety symptoms, which were gradually reduced as resilience increased. The direct associations between brooding, reflection and rumination and poor sleep quality were not significantly moderated by resilience. Thus, a moderated mediation model involving anxiety symptoms and resilience for explaining the impact of rumination on poor sleep quality was supported among patients with NAFLD. CONCLUSIONS Rumination (including brooding and reflection) could be positively related to poor sleep quality, and anxiety symptoms had a significant role in accounting for the relationship among patients with NAFLD. Resilience showed a moderating role that could attenuate the positive association between rumination and anxiety symptoms. Interventions aimed at alleviating rumination, reducing anxiety symptoms, and enhancing resilience could improve the sleep quality of NAFLD patients.
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Affiliation(s)
- Xiaolin Chang
- grid.412636.40000 0004 1757 9485Outpatient Service By Famous Specialists, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Chenxi Guo
- grid.412636.40000 0004 1757 9485Department of Clinical Nutrition, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Heng Zhou
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, Shenyang, China. .,Department of Anesthesiology, The First Affiliated Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning, China.
| | - Li Liu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China.
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14
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Simegn W, Yohannes L, Seid AM, Kasahun AE, Sema FD, Flatie A, Elias A, Dagne H. Perceived stress and associated factors among university students in Ethiopia during the late stage of the COVID-19 pandemic: A cross-sectional study. Front Psychol 2022; 13:978510. [PMID: 36405123 PMCID: PMC9670151 DOI: 10.3389/fpsyg.2022.978510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background During extensive outbreaks of infectious diseases, people who are impacted, particularly the subgroups of the community who are at an increased risk of mental health problems, may experience increased stress and mental health difficulties. University students are one such susceptible population and are prone to experiencing high levels of stress as compared with the general population. Therefore, this study aimed at assessing perceived stress and identifying its associated factors among university students in Ethiopia during the late stage of the COVID-19 pandemic. Methods A cross-sectional study was conducted among university students in Ethiopia from 30 May to 30 June 2021. Students were asked to fill out an online survey on Google Forms that included consent, sociodemographic information, the UCLA-8 Loneliness Scale, the standard validated stress scale (PSS-10) questionnaire, and the three-item Oslo Social Support Scale (OSSS-3) to assess social support. The collected data were exported to SPSS 26. Descriptive and analytical statistics were carried out. Binary and multiple logistic regression analyses were performed to find associated factors, and variables with a p-value of 0.05 were considered statistically significant variables. Results A total of 426 university students were included in the survey, among whom 268 (62.9%) were male participants. The age of the participants ranged from 18 to 37 years. Health-related departments accounted for 37.1% of the participants, while non-health-related departments accounted for 62.9%. The prevalence of stress was 18.3% in the study population. In this study, extreme susceptibility to COVID-19, sleeping problems, poor self-efficacy to prevent COVID-19, and loneliness were significantly associated with perceived stress. Conclusion Stress was prevalent among university students in Ethiopia during the late stage of the COVID-19 pandemic. Extreme susceptibility to COVID-19, sleeping problems, poor self-efficacy, and loneliness were identified as factors for stress. Therefore, we suggest that universities should provide opportunities for safe social connection, counseling, and guidance for students.
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Affiliation(s)
- Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Lamrot Yohannes
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | | | - Asmamaw Emagn Kasahun
- Department of Pharmaceutics, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Faisel Dula Sema
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Adane Flatie
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Asrat Elias
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Henok Dagne
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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15
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Psychological resilience mediates the association of the middle frontal gyrus functional connectivity with sleep quality. Brain Imaging Behav 2022; 16:2735-2743. [DOI: 10.1007/s11682-022-00735-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/02/2022]
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16
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Kwon M, Wang J, Dean GE, Dickerson SS. Sleep health, its intraindividuality, and perceived stress in college students during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-12. [PMID: 36194424 DOI: 10.1080/07448481.2022.2128684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/12/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
Objective: To describe the changes in sleep health domains and examine the associations between the repeated measures and intraindividual variability (IIV) of these domains and perceived stress. Participants: A diverse racial and ethnic group of first-year college students (N = 23, 78.3% female, aged 17-18) attending in-person classes during the COVID-19 pandemic. Methods: Sleep health domains were determined using 7-day wrist actigraph and daily sleep diaries, and perceived stress scale was completed at 1-month intervals across 3 months. Results: Sleep timing, regularity, and alertness during daytime demonstrated statistically significant changes between three timepoints. Greater stress was associated with more irregularity (B = 2.25 [.87-3.62], p < .001), more dissatisfaction in sleep (B = .04 [.02-.19], p < .01), alertness during daytime (B = .18 [.05-.31], p < .001), and greater IIV (ie, fluctuations) in sleep satisfaction (B = .083 [.02, .15], p < .01). Conclusion: These findings offer insights for future researchers to facilitate intervention development to promote mental and sleep health among college students.
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Affiliation(s)
- Misol Kwon
- School of Nursing, University at Buffalo, State University of New York, New York, USA
| | - Jia Wang
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, State University of New York, New York, USA
| | - Grace E Dean
- School of Nursing, University at Buffalo, State University of New York, New York, USA
| | - Suzanne S Dickerson
- School of Nursing, University at Buffalo, State University of New York, New York, USA
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17
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Zhang Q, Song D, Liu Y, Chang L, Li C, Li Y. Sleep quality, caregiver burden, and individual resilience among parents of children with epilepsy. Epilepsy Behav 2022; 135:108873. [PMID: 35973374 DOI: 10.1016/j.yebeh.2022.108873] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Parents caring for children with epilepsy have poor sleep quality and experience a certain level of caregiving burden. Individual resilience is a crucial psychological variable that contributes to health during extraordinary challenges. This study aimed to determine the relationships among individual resilience, caregiver burden, and sleep quality. METHODS This was a descriptive cross-sectional study with a convenience sample, following the STROBE guidelines. One hundred and ninety-one parents of children with epilepsy were invited to participate in the study. Of these, 173 participants completed measures of sleep quality, caregiver burden, and individual resilience. Path analysis was performed to probe the indirect relationship between individual resilience and sleep quality via caregiver burden. RESULTS Correlation analysis revealed that individual resilience total scores were significantly and marginally negatively correlated with caregiver burden and sleep quality total scores (r = -0.215, P <.01; r = -0.250, P <.01). Moreover, there was a significant moderate positive correlation between the total caregiver burden scores and total sleep quality scores (r = 0.389, P <.001). The path model showed that individual resilience is indirectly associated with sleep quality via caregiver burden. CONCLUSION The higher the level of individual resilience, the less the caregiver burden and the better the sleep quality for parents of children with epilepsy.
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Affiliation(s)
- Qin Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China
| | - Dongyu Song
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China
| | - Yuzhou Liu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China
| | - Lixia Chang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China
| | - Chenglin Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China
| | - Yuli Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China.
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Examining Perceived Stress and Coping Strategies of University Students during COVID-19: A Cross-Sectional Study in Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159154. [PMID: 35954508 PMCID: PMC9368044 DOI: 10.3390/ijerph19159154] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023]
Abstract
COVID-19 has changed our lives in all arenas, including higher education and psychological well-being. Three objectives were set forth in this study. We started by examining issues related to online education during the pandemic in Jordan, particularly for students pursuing business studies. Second, we assessed academic, behavioural, and financial stressors that business students experience at Jordanian higher education institutions. Lastly, we examined the possible coping methods students employed to cope and adapt during the pandemic. A descriptive cross-sectional study was conducted based on the perceived stress scale distributed to 473 Jordanian undergraduate students (18–27 years of age), across both public and private universities. Results showed an association between academic, behavioural, and financial stressors and students’ perceived stress. While students perceived various levels and types of stress during COVID-19, including academic, behavioural, and financial, they also experienced new online skills. However, despite coping with stress, some students (especially females) displayed more stress because of the deficient course content, which added to their perceived stress and left them feeling unmotivated. This study contributes to bettering the university students’ mental health.
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19
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Schnell T, Krampe H. Meaningfulness protects from and crisis of meaning exacerbates general mental distress longitudinally. BMC Psychiatry 2022; 22:285. [PMID: 35448989 PMCID: PMC9023037 DOI: 10.1186/s12888-022-03921-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/25/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Reactions to the COVID-19 pandemic are diverse, and both mental distress and existential crises can arise. The identification of protective and exacerbating factors and their progress over time is therefore highly relevant. The current study examined longitudinal protective effects of meaningfulness and exacerbating effects of crisis of meaning on general mental distress. METHODS N = 431 participants from Germany and Austria (mean age: 42 years) completed an online survey in both April/May (T1) and July/August 2020 (T2). After determining temporal stability or changes in meaningfulness, crisis of meaning, and general mental distress (PHQ-4), we examined whether (i) meaningfulness and (ii) crisis of meaning, measured at T1, incrementally predicted PHQ-4 at T2, beyond baseline levels of PHQ-4. We further tested (iii) a within-subject mediation of temporal changes in PHQ-4 by changes in crisis of meaning. RESULTS Meaningfulness prospectively predicted lower PHQ-4, and crisis of meaning predicted higher PHQ-4. From the first wave of the pandemic until a slowdown three months later, meaningfulness was stable, and crisis of meaning and PHQ-4 decreased. Changes in crisis of meaning mediated the changes in PHQ-4. CONCLUSIONS Meaningfulness appears to have a protective, and crisis of meaning an exacerbating effect on psychological distress, as shown here for the time of the first pandemic wave until three months later. Attention to existential experiences of meaningfulness and loss of meaning thus proves relevant to the clinical and public health context. Measures that support meaningfulness will help coping with crises of meaning, which in turn supports overcoming general mental distress.
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Affiliation(s)
- Tatjana Schnell
- Psychology of Religion and Existential Psychology, Social Sciences, MF Specialized University, Gydas vei 4, 0363, Oslo, Norway.
- Institute of Psychology, Existential Psychology Lab, University of Innsbruck, Innrain 52, 6020, Innsbruck, Austria.
| | - Henning Krampe
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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20
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Li Q, Hu J. Post-traumatic Growth and Psychological Resilience During the COVID-19 Pandemic: A Serial Mediation Model. Front Psychiatry 2022; 13:780807. [PMID: 35386520 PMCID: PMC8977484 DOI: 10.3389/fpsyt.2022.780807] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/15/2022] [Indexed: 12/15/2022] Open
Abstract
Although the World Health Organization (WHO) has issued guidelines for managing to contain, mitigate, and limit of the COVID-19. However, it is more essential to highlight the urgency and importance of evaluating social functioning and mental health status during the pandemic. College students have experienced serious problems and have had to overcome many negative situations brought about by the pandemic. Accordingly, the present study intended to use Chinese college students as sample to examine the positive adoption and changes during the ongoing COVID-19. Guided by literatures in this filed, we explored the internal mechanism of post-traumatic growth affecting psychological resilience, and considered about mediation roles of positive coping styles and cognitive reappraisal. A total of 463 college students from universities in China effectively completed online questionnaires. The result indicated that these four variables were positively correlated with each other (ps < 0.001). More importantly, our findings proved a direct and positive effect on psychological resilience. Positive coping styles and cognitive reappraisal, respectively, mediated the relationship between post-traumatic growth and psychological resilience. Over all, the hypothesized serial model conclusively fits the data: students with high-level post-traumatic growth tended to report increased use of positive coping strategies, which further facilitated their cognitive reappraisal, and subsequently, promoted their psychological resilience. The findings obtained in this study will provide a theoretical basis and possible viable strategies for both targeted crisis intervention and psychological trauma recovery plans.
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Affiliation(s)
| | - Jinsheng Hu
- Department of Psychology, Liaoning Normal University, Dalian, China
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21
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Du C, Adjepong M, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Keaver L, Lee H, Ludy MJ, Shen W, Swee WCS, Thrivikraman J, Amoah-Agyei F, de Kanter E, Wang W, Tucker RM. Gender Differences in the Relationships between Perceived Stress, Eating Behaviors, Sleep, Dietary Risk, and Body Mass Index. Nutrients 2022; 14:1045. [PMID: 35268020 PMCID: PMC8912409 DOI: 10.3390/nu14051045] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Obesity is a growing epidemic among university students, and the high levels of stress reported by this population could contribute to this issue. Singular relationships between perceived stress; engagement in restrained, uncontrolled, and emotional eating; sleep; dietary risk; and body mass index (BMI) have been reported in the current body of literature; however, these constructs interact with each other, and the complex relationships among them are infrequently examined. Therefore, the aim of the present study was to explore the complex relationships between these constructs using mediation and moderation analyses stratified by gender. METHODS A cross-sectional study, enrolling university students from the United States (U.S.), the Netherlands, South Korea, Malaysia, Ireland, Ghana, and China, was conducted between October 2020 and January 2021 during the COVID-19 pandemic. Perceived stress; maladaptive eating behaviors including restrained, uncontrolled, and emotional eating; sleep duration and quality; dietary risk; and BMI were assessed using validated questionnaires, which were distributed through an online platform. RESULTS A total of 1392 students completed the online survey (379 male, 973 female, and 40 who self-identified as "other"). Uncontrolled and emotional eating mediated the relationship between perceived stress and dietary risk for both males and females; higher sleep quality weakened this relationship among female students but not males. Emotional eating mediated the relationship between perceived stress and BMI for both males and females, but higher sleep quality weakened this relationship only among females. CONCLUSIONS Our findings suggest that students in higher education are likely to benefit from interventions to reduce uncontrolled and emotional eating. Programs that improve sleep quality, especially during highly stressful periods, may be helpful.
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Affiliation(s)
- Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (W.W.)
| | - Mary Adjepong
- Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana; (M.A.); (F.A.-A.)
| | - Megan Chong Hueh Zan
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Min Jung Cho
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.); (E.d.K.)
| | - Jenifer I. Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (W.W.)
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Laura Keaver
- Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland;
| | - Heesoon Lee
- Department of Human Services, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Mary-Jon Ludy
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Wan Shen
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Winnie Chee Siew Swee
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Jyothi Thrivikraman
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.); (E.d.K.)
| | - Felicity Amoah-Agyei
- Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana; (M.A.); (F.A.-A.)
| | - Emilie de Kanter
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.); (E.d.K.)
| | - Wenyan Wang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (W.W.)
| | - Robin M. Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (W.W.)
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22
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Xu H, Yang X, Lai X, Zhao C, Tu X, Ding N, Ruan S, Jiang Y, Lv Y, Zhang G. Longitudinal relationships among perceived stress, suicidal ideation and sleep quality in Chinese undergraduates: A cross-lagged model. J Affect Disord 2022; 299:45-51. [PMID: 34813870 DOI: 10.1016/j.jad.2021.11.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/25/2021] [Accepted: 11/13/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Sleep quality is an important indicator of quality of life. It is of importance to investigate the risk factors and potential consequences of poor sleep quality, such as perceived stress and suicidal ideation. We therefore investigated the longitudinal and reciprocal relationships among perceived stress, suicidal ideation, and sleep quality. METHODS A three-wave longitudinal survey was conducted from June 2019 to June 2020 at six-month intervals in undergraduate students (N = 197, 58.9% female) in China. The participants completed self-report questionnaires in classroom settings. RESULTS While the levels of perceived stress were stable, levels of suicidal ideation and sleep quality fluctuated significantly over time. There were significant reciprocal relationships between perceived stress and suicidal ideation from T1 to T3. In addition, the reciprocal relationships between suicidal ideation and sleep quality from T1 to T2 were also significant. Suicidal ideation at T2 partially mediated the relationship between perceived stress at T1 and sleep quality at T3 (indirect effect: β=0.06, 95% CI: 0.04 to 0.10, p<0.001), and suicidal ideation at T2 fully mediated the relationship between sleep quality at T1 and perceived stress at T3 (indirect effect: β=0.48, 95% CI: 0.30, 0.70, p<0.001). LIMITATIONS The subjects' educational background is single, and the measurement method is self-report measures. CONCLUSIONS Suicidal ideation may play a significant role in explaining the longitudinal relationships between perceived stress and sleep quality. And suggest the importance of early identification and treatment of suicidal ideation among Chinese undergraduates.
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Affiliation(s)
- Huihui Xu
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Xue Yang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xinyi Lai
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Chengjia Zhao
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou 325035, China
| | - Xiaolian Tu
- Renji College, Wenzhou Medical University, Wenzhou 325035, China.
| | - Nani Ding
- School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, China.
| | - Songli Ruan
- Henan University of Urban Construction, Pingdingshan 467000, China.
| | - Yile Jiang
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou 325035, China.
| | - Yijun Lv
- Wenzhou Medical University, Wenzhou 325035, China.
| | - Guohua Zhang
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou 325035, China; The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325035, China; Institute Of Aging, Key Laboratory Of Alzheimer's Disease Of Zhejiang Province, Wenzhou Medical University, Wenzhou 325035, China.
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Relationships between Dairy and Calcium Intake and Mental Health Measures of Higher Education Students in the United States: Outcomes from Moderation Analyses. Nutrients 2022; 14:nu14040775. [PMID: 35215428 PMCID: PMC8877188 DOI: 10.3390/nu14040775] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/02/2022] [Accepted: 02/11/2022] [Indexed: 12/11/2022] Open
Abstract
Background: The prevalence of mental health concerns among university students in the United States (U.S.) continues to increase, while current treatments, including medication and counseling, present shortcomings. Higher dairy and calcium intakes are associated with protective effects on mental health; however, previous studies have focused on investigating singular relationships between dairy and calcium intakes and mental health measures. A more complex exploration of these relationships is warranted to better examine whether increasing dairy and calcium intakes could serve as an intervention to improve mental health. The present study sought to further characterize the relationships between dairy and calcium intake, perceived stress, and a variety of mental health measures using linear regression and moderation analyses. Methods: The present cross-sectional study involved students studying at three large U.S. universities, and data collection occurred from April to May 2020 when students were learning remotely due to the COVID-19 pandemic. An online survey comprising validated tools was distributed among students to assess dairy and calcium intake, perceived stress, anxiety, negative and positive moods, rumination, and resilience, sleep quality and duration, dietary risk, and physical activity. Results: A total of 1233 students completed the study. Higher dairy and calcium intake was coincident with lower perceived stress and higher positive mood scores, while higher calcium intake was also coincident with lower anxiety, rumination, and higher resilience scores. Additionally, as calcium intake increased, the relationship between perceived stress and anxiety and the relationship between perceived stress and negative mood weakened. Dairy intake did not have this effect. Conclusions: Based on the results, and considering that calcium is a shortfall nutrient, universities should consider initiating programs and public health campaigns to promote dairy and calcium intake among this population.
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Kumar VV, Tankha G. The Relationship between Personality Traits and COVID-19 Anxiety: A Mediating Model. Behav Sci (Basel) 2022; 12:bs12020024. [PMID: 35200276 PMCID: PMC8869446 DOI: 10.3390/bs12020024] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/10/2022] [Accepted: 01/21/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has created a lot of fear and anxiety globally. The current study attempted to investigate the association among the big five personality traits and the two factors of COVID-19 pandemic anxiety (fear and somatic concern). Further, sleep quality as a mediator between personality traits and pandemic anxiety was also assessed. The study involved a cross-sectional sample of 296 adult Indians who were administered the 10-item short version of BFI along with the COVID-19 Pandemic Anxiety Scale and Sleep Quality Scale. Path analysis was used to test the theoretical model that we proposed. The overall model has explained 6% and 36% of the variance, respectively, for the factors of fear and somatic concern of COVID-19 pandemic anxiety. The path analysis model indicated that only the trait of neuroticism showed a significant direct and indirect effect on pandemic anxiety in the sample. Those scoring high on neuroticism indicated high levels of fear as well as somatic concern. Neuroticism also showed partial mediation through sleep quality on the factor of somatic concern. Agreeableness was the only other personality trait that indicated a significantly negative relationship with the factor of somatic concern. These relationships were independent of age, gender, and occupational status. These findings provide a preliminary insight into the slightly different relationship which has emerged between personality and COVID-19 pandemic anxiety in comparison to general anxiety.
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Limited negative effects of the COVID-19 pandemic on mental health measures of Ghanaian university students. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 7:100306. [PMID: 35018355 PMCID: PMC8731225 DOI: 10.1016/j.jadr.2021.100306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/09/2021] [Accepted: 12/31/2021] [Indexed: 11/23/2022] Open
Abstract
Background Stress and mental health outcomes are negatively correlated among university students throughout the world. Reports of differences in stress perception by gender exist, but there is limited data on students from sub-Saharan African countries. This study describes the burden of perceived and financial stress; characterizes mood and degree of anxiety symptoms; examines stress coping mechanisms, including resilience and repetitive negative thinking (RNT); and explores how students at a Ghanaian university believed the COVID-19 pandemic affected these measures. Methods Students (n = 129) were recruited from the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana from October 2020 - January 2021. Validated surveys were used. Participants were asked "Are your answers to the questions affected by the COVID-19 pandemic?" Results No differences in mean scores were observed between genders. For female students, financial stress was positively associated with RNT (p = 0.009), negative mood (p = 0.002), and anxiety (p < 0.001). Males were more likely to report decreased stress during the pandemic (p = 0.002), but there was no difference in mental health outcomes by perceived stress (PS) change category among males. Effects of the pandemic on mental health outcomes were mixed, but substantial proportions of students reported improvements or no change in financial stress, mood, anxiety, and RNT. Limitations Students from one university particiapted in this cross-sectional survey. Conclusions This study adds to the understanding of how higher education students are experiencing stress and are coping with the uncertainties of the COVID-19 pandemic in Ghana.
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Musetti A, Gori A, Alessandra A, Topino E, Terrone G, Plazzi G, Cacioppo M, Franceschini C. The Interplay Between Problematic Online Pornography Use, Psychological Stress, Emotion Dysregulation and Insomnia Symptoms During the COVID-19 Pandemic: A Mediation Analysis. Nat Sci Sleep 2022; 14:83-92. [PMID: 35082545 PMCID: PMC8786338 DOI: 10.2147/nss.s348242] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/13/2022] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Although a link between problematic online pornographic use (POPU) and insomnia symptoms has been established, psychological and psychopathological mechanisms underlying this relationship are still not clear. Psychological stress and emotion dysregulation have been pointed out as relevant in the development and maintenance of insomnia. This study aims to explore the associations between POPU, psychological stress, emotion dysregulation and insomnia symptoms and to understand the mediating role of psychological stress and emotion dysregulation in the relationship between POPU and insomnia symptoms. PARTICIPANTS AND METHODS A sample of 776 Italian adults aged 19-48 years (51.4% female; M age = 28.49; SD = 7.33) completed questionnaires regarding demographics, COVID-19-related variables, POPU, psychological stress, emotion dysregulation, and insomnia symptoms. RESULTS After controlling for demographic covariates and COVID-19-related variables, multiple mediation model showed that higher psychological stress and emotion dysregulation fully mediated the link between POPU and insomnia. CONCLUSION The findings underscore the significance of the negative consequences of POPU and underline the importance of working on this and its effects on psychological stress and emotion dysregulation to limit insomnia.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Alessio Gori
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Eleonora Topino
- Department of Human Sciences, Lumsa University of Rome, Rome, Italy
| | - Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,IRCCS Institute of Neurological Sciences of Bologna (ISNB), Bologna, Italy
| | - Marco Cacioppo
- Department of Human Sciences, Lumsa University of Rome, Rome, Italy
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Kara B. Understanding the psychological impact of the COVID-19 pandemic on university students. AIMS MEDICAL SCIENCE 2022. [DOI: 10.3934/medsci.2022001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Lenzo V, Sardella A, Musetti A, Freda MF, Lemmo D, Vegni E, Borghi L, Plazzi G, Palagini L, Castelnuovo G, Cattivelli R, Mariani R, Michelini G, Manari T, Saita E, Quattropani MC, Franceschini C. The Relationship Between Resilience and Sleep Quality During the Second Wave of the COVID-19 Pandemic: A Longitudinal Study. Nat Sci Sleep 2022; 14:41-51. [PMID: 35023980 PMCID: PMC8747773 DOI: 10.2147/nss.s344042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/22/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Previous studies showed poor sleep quality during the first Italian lockdown consequent to the quick spread of the virus. Poor sleep quality remained stable during the so-called "second wave", which started in Autumn 2020. This study aimed to compare sleep quality between the two waves of contagions and to examine the effect of resilience, together with sociodemographic and COVID-related variables, on sleep quality during the second wave. PATIENTS AND METHODS A total of 648 participated in this longitudinal study through an online survey during the first lockdown consequent to the COVID-19 and during the second wave. The Medical Outcomes Study-Sleep Scale (MOS-SS) and the Resilience Scale (RS) were administered. Sociodemographic and COVID-related information were also collected. RESULTS The results showed sleep quality slightly increased in the second wave, even though with a small effect size. Correlational analysis showed that resilience is inversely correlated with sleep quality measured in the two waves. Sleep quality during the second wave was positively correlated with sleep quality in the first lockdown. Likewise, the results of multiple regression revealed that the sleep quality in the first lockdown and resilience were significant predictors of sleep quality during the second wave. CONCLUSION These findings highlighted that the prevalence of poor sleepers remained high during the second wave. Together with the sleep quality in the first lockdown, resilience represents an important factor related to sleep quality during the second wave. Interventions to improve sleep quality among the general population should take into account these findings.
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Affiliation(s)
- Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, University for Foreigners "Dante Alighieri" of Reggio Calabria, Reggio, Calabria, Italy
| | - Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | | | - Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Laura Palagini
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy.,Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | | | - Rachele Mariani
- Department of Dynamic and Clinical Psychology, University of Rome "La Sapienza", Roma, Italy
| | | | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of Milan, Milan, Italy
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Psychological Wellbeing, Worry, and Resilience-Based Coping during COVID-19 in Relation to Sleep Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010050. [PMID: 35010309 PMCID: PMC8744958 DOI: 10.3390/ijerph19010050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 01/15/2023]
Abstract
The current study evaluated the impact of psychological wellbeing on sleep quality during the onset of the COVID-19 pandemic. A novel empirical model tested variables that mediate and moderate this impact. First, a relationship was established between psychological wellbeing during the COVID-19 pandemic and sleep quality. Second, resilience-based coping associated with the COVID-19 pandemic was tested as a mediator of the impact of psychological wellbeing on sleep quality. Third, dispositional rumination, mindfulness, and worry were compared as moderators of the impact of psychological wellbeing on sleep quality. Fourth, a moderated mediated model was tested for each moderator. Online survey data was collected from 153 adults in the United States. Results demonstrated that coping with the COVID-19 pandemic partially mediated the impact of psychological wellbeing on sleep quality. Worry, but not rumination or mindfulness, moderated the impact. A moderated mediation model failed to demonstrate significance, indicating that the data are best represented by distinct mediation and moderation models. Thus, interventions aimed at improving sleep quality should prioritize concurrent reduction in worry and increase in resilience-based coping strategies. This study provides practical and theoretical contribution to the literature by demonstrating relationships between key variables and contextualizing how the model can be used for assessments and interventions during widespread crises.
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Zhu J, Racine N, Xie EB, Park J, Watt J, Eirich R, Dobson K, Madigan S. Post-secondary Student Mental Health During COVID-19: A Meta-Analysis. Front Psychiatry 2021; 12:777251. [PMID: 34955924 PMCID: PMC8709535 DOI: 10.3389/fpsyt.2021.777251] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/05/2021] [Indexed: 12/11/2022] Open
Abstract
The COVID-19 pandemic has posed notable challenges to post-secondary students, causing concern for their psychological well-being. In the face of school closures, academic disruptions, and constraints on social gatherings, it is crucial to understand the extent to which mental health among post-secondary students has been impacted in order to inform support implementation for this population. The present meta-analysis examines the global prevalence of clinically significant depression and anxiety among post-secondary students during the COVID-19 pandemic. Several moderator analyses were also performed to examine sources of variability in depression and anxiety prevalence rates. A systematic search was conducted across six databases on May 3, 2021, yielding a total of 176 studies (1,732,456 participants) which met inclusion criteria. Random-effects meta-analyses of 126 studies assessing depression symptoms and 144 studies assessing anxiety symptoms were conducted. The pooled prevalence estimates of clinically elevated depressive and anxiety symptoms for post-secondary students during the COVID-19 pandemic was 30.6% (95% CI: 0.274, 0.340) and 28.2% (CI: 0.246, 0.321), respectively. The month of data collection and geographical region were determined to be significant moderators. However, student age, sex, type (i.e., healthcare student vs. non-healthcare student), and level of training (i.e., undergraduate, university or college generally; graduate, medical, post-doctorate, fellow, trainee), were not sources of variability in pooled rates of depression and anxiety symptoms during the pandemic. The current study indicates a call for continued access to mental health services to ensure post-secondary students receive adequate support during and after the COVID-19 pandemic. Systematic Review Registration: PROSPERO website: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021253547.
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Affiliation(s)
- Jenney Zhu
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Nicole Racine
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | | | - Julianna Park
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Julianna Watt
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Rachel Eirich
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Keith Dobson
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
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Dessauvagie AS, Dang HM, Nguyen TAT, Groen G. Mental Health of University Students in Southeastern Asia: A Systematic Review. Asia Pac J Public Health 2021; 34:172-181. [PMID: 34798781 PMCID: PMC8978462 DOI: 10.1177/10105395211055545] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Mental health in young people is a public health challenge worldwide, with around
one-fifth of university students suffering from a 12-month mental disorder. In
low- and middle-income countries (LMICs) of Southeastern Asia, resources for
mental health are limited and counseling services are not regularly established
at universities. This review aims to determine the prevalence of mental health
problems among university students in six ASEAN (Association of Southeast Asian
Nations) countries (Cambodia, Laos, Malaysia, Myanmar, Thailand, and Vietnam)
and to identify the determinants of mental health. A systematic database search
(PubMed, CINAHL, PsycINFO, PubPsych, and Scopus) for peer-reviewed, English
language articles, published 2010-2020, reporting prevalence data based on
standardized screening instruments resulted in 335 articles; 108 were eligible
for full-text analysis, of which 34 could be included in the review. Median
point prevalence was 29.4% for depression, 42.4% for anxiety, 16.4% for stress,
and 13.9% for disordered eating. Current suicidality was present in 7% to 8% of
students. There was a high rate of psychiatric comorbidity. Despite the high
prevalence of mental health problems, the willingness to seek professional help
was comparatively low. Implications for mental health promotion and prevention
in university settings are discussed.
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Affiliation(s)
| | - Hoang-Minh Dang
- Center for Research, Information and Service in Psychology (CRISP), VNU University of Education, Hanoi, Vietnam
| | - Thi Anh Thu Nguyen
- Department of Educational Psychology, VNUHCM-University of Social Sciences and Humanities, Ho Chi Minh City, Vietnam
| | - Gunter Groen
- Department of Social Work, Hamburg University of Applied Sciences, Hamburg, Germany
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Lin SY, Chung KKH. Risk Perception, Perception of Collective Efficacy and Sleep Quality in Chinese Adults during COVID-19 Pandemic in Hong Kong: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111533. [PMID: 34770053 PMCID: PMC8583171 DOI: 10.3390/ijerph182111533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/28/2021] [Accepted: 10/31/2021] [Indexed: 12/20/2022]
Abstract
Background: Only a few studies have studied the link between risk perception and sleep in the context of the COVID-19 pandemic. The purpose of our study is to propose and test a theoretical model to understand the relationships between COVID-19 risk appraisals—risk perception and perception of collective coordinated defense (PCCD) in particular—and subjective sleep quality in Chinese adults in Hong Kong during the COVID-19 pandemic. COVID-19-related fear and rumination were examined as potential mediators of the relationships. Methods: Data were collected using a self-report online questionnaire from a convenience sample of 224 Chinese adults during the fourth wave of the COVID-19 pandemic in Hong Kong. Results: Risk perception and PCCD were found to predict poor sleep quality. Mediation analysis showed that both fear and rumination mediated the relationship between risk perception and sleep quality, whereas only fear mediated the relationship between PCCD and sleep quality. The model was an excellent fit to the data and accounted for 44% of the variance in sleep quality in Chinese adults. This study indicated that both perception of high risks of contracting COVID-19 and anticipations of collective disease preventive efforts had adverse effects on subjective sleep quality via increasing COVID-19-related fear. Conclusions: These findings underscore the need for addressing sleep problems induced by psychological consequences of the pandemic. While policy makers often deliver public messaging campaigns that frame disease prevention as a collective goal, developing evidence-based coping strategies to combat COVID-19 adverse impacts on psychological health is equally important.
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Affiliation(s)
- Shiang-Yi Lin
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po, Hong Kong, China;
- Division of Social Science, Hong Kong University of Science and Technology, Kowloon, Hong Kong, China
| | - Kevin Kien Hoa Chung
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po, Hong Kong, China;
- Centre for Child and Family Science, The Education University of Hong Kong, Tai Po, Hong Kong, China
- Correspondence: ; Tel.: +852-29487760
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Gargiulo AT, Peterson LM, Grafe LA. Stress, coping, resilience, and sleep during the COVID-19 pandemic: A representative survey study of US adults. Brain Behav 2021; 11:e2384. [PMID: 34661981 PMCID: PMC8613418 DOI: 10.1002/brb3.2384] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic is a global health emergency resulting in widespread death and substantial disruption to daily life. Previous research has shown that novel disease outbreaks are associated with high stress levels and sleep impairments that lead to neuropsychiatric consequences. Therefore, it is vital to study both stress and protective factors such as coping and resilience that may hinder or help sleep quality during the COVID-19 pandemic. Further, as gender disparities exist in sleep quality, it is important to understand the relationship between pandemic-related stress, coping strategies, resilience, and sleep in bothgenders during the COVID-19 pandemic. METHODS Our study examined how gender, stress, coping, and resilience were associated with sleep cross-sectionally during the COVID-19 pandemic in a representative sample of US adults (N = 393). RESULTS Consistent with many recent studies, we found that worsened sleep quality in women compared to men persisted during the COVID-19 pandemic. Interestingly, pandemic-related stress was not significantly associated with sleep quality, but pandemicrelated coping was associated with sleep independent of robust controls and trait resilience. CONCLUSIONS Greater primary control engagement coping was associated with better sleep quality, while involuntary engagement coping was associated with poor sleep quality. Future research should extend the findings with actigraphy and explore ways to enhance beneficial coping and sleep health during pandemics.
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Affiliation(s)
- Andrew T. Gargiulo
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
| | - Laurel M. Peterson
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
| | - Laura A. Grafe
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
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Krampe H, Danbolt LJ, Haver A, Stålsett G, Schnell T. Locus of control moderates the association of COVID-19 stress and general mental distress: results of a Norwegian and a German-speaking cross-sectional survey. BMC Psychiatry 2021; 21:437. [PMID: 34488667 PMCID: PMC8419811 DOI: 10.1186/s12888-021-03418-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/03/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND An internal locus of control (LoC I) refers to the belief that the outcome of events in one's life is contingent upon one's actions, whereas an external locus of control (LoC E) describes the belief that chance and powerful others control one's life. This study investigated whether LoC I and LoC E moderated the relationship between COVID-19 stress and general mental distress in the general population during the early months of the COVID-19 pandemic. METHODS This cross-sectional survey study analysed data from a Norwegian (n = 1225) and a German-speaking sample (n = 1527). We measured LoC with the Locus of Control-4 Scale (IE-4), COVID-19 stress with a scale developed for this purpose, and mental distress with the Patient Health Questionnaire 4 (PHQ-4). Moderation analyses were conducted using the PROCESS macro for SPSS. RESULTS The association between COVID-19 stress and general mental distress was strong (r = .61 and r = .55 for the Norwegian and the German-speaking sample, respectively). In both samples, LoC showed substantial moderation effects. LoC I served as a buffer (p < .001), and LoC E exacerbated (p < .001) the relation between COVID-19 stress and general mental distress. CONCLUSIONS The data suggest that the COVID-19 pandemic is easier to bear for people who, despite pandemic-related strains, feel that they generally have influence over their own lives. An external locus of control, conversely, is associated with symptoms of depression and anxiety. The prevention of mental distress may be supported by enabling a sense of control through citizen participation in policy decisions and transparent explanation in their implementation.
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Affiliation(s)
- Henning Krampe
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lars Johan Danbolt
- Practical Theology, MF Norwegian School of Theology, Religion and Society, Oslo, Norway
- Centre for Psychology of Religion, Innlandet Hospital Trust, Ottestad, Norway
| | - Annie Haver
- Faculty of Social Sciences, Norwegian School of Hotel Management, University of Stavanger, Stavanger, Norway
- Faculty of Social Sciences, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Gry Stålsett
- Social Sciences, MF Norwegian School of Theology, Religion and Society, Oslo, Norway
- Modum Bad Psychiatric Center, Vikersund, Norway
| | - Tatjana Schnell
- Social Sciences, MF Norwegian School of Theology, Religion and Society, Oslo, Norway.
- Existential Psychology Lab, Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
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Deng J, Zhou F, Hou W, Silver Z, Wong CY, Chang O, Drakos A, Zuo QK, Huang E. The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res 2021; 301:113863. [PMID: 33984824 PMCID: PMC9225824 DOI: 10.1016/j.psychres.2021.113863] [Citation(s) in RCA: 189] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/06/2021] [Indexed: 12/12/2022]
Abstract
The COVID-19 pandemic and its accompanying infection control measures introduced significant disruptions to the routines of many higher education students around the world. It also deprived them of in-person counselling services and social support. These changes have put students at a greater risk of developing mental illness. The objective of this review is to assess the prevalence of depressive symptoms, anxiety symptoms and sleep disturbances in higher education students during the pandemic. A systematic search of English and Chinese databases was conducted current to January 1st, 2021. The quality of included studies was evaluated using a modified Newcastle-Ottawa scale. Prevalence of depressive symptoms, anxiety symptoms and sleep disturbances were pooled using random-effects meta-analysis. Eighty-nine studies (n=1,441,828) were included. The pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances was 34%, 32% and 33%, respectively. The prevalence values differ based on geographical regions, diagnostic criteria, education level, undergraduate year of study, financial situation, living arrangements and gender. Overall, the prevalence of depressive symptoms and anxiety symptoms synthesized in this study was higher compared to pre-pandemic prevalence in similar populations. Evidently, mental health screening and intervention should be a top priority for universities and colleges during the pandemic.
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Affiliation(s)
- Jiawen Deng
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada.
| | - Fangwen Zhou
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Wenteng Hou
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Zachary Silver
- Faculty of Science, Carleton University, 1125 Colonel By Dr, Ottawa, ON K1S 5B6, Canada
| | - Chi Yi Wong
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Oswin Chang
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Anastasia Drakos
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Qi Kang Zuo
- Department of Anesthesiology, Rutgers, New Jersey Medical School, 185 S Orange Ave, Newark, New Jersey 07103, USA
| | - Emma Huang
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
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Armand MA, Biassoni F, Corrias A. Sleep, Well-Being and Academic Performance: A Study in a Singapore Residential College. Front Psychol 2021; 12:672238. [PMID: 34135831 PMCID: PMC8200680 DOI: 10.3389/fpsyg.2021.672238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/27/2021] [Indexed: 01/07/2023] Open
Abstract
We examined the relationship between sleep and the affective components of subjective well-being as well as psychological well-being, and between sleep and academic performance, of full-time undergraduate students in a residential college at the National University of Singapore. The aspects of sleep considered were self-reported sleep duration, sleep efficiency, frequency of sleep disturbances, daytime dysfunction, sleep latency and overall sleep quality, as measured by the Pittsburgh Sleep Quality Index. Academic performance was measured using self-reported cumulative average point scores, typically known as grade point average in other institutions. Psychological well-being and the affective components of subjective well-being were assessed using the Flourishing Scale and the Scale of Positive and Negative Experience, respectively. With the exception of sleep latency, our univariate analysis revealed significant associations between the abovementioned facets of sleep, and the affective components of subjective well-being. The analysis also revealed significant associations between the above sleep variables and psychological well-being, except sleep latency and frequency of sleep disturbances. Only daytime dysfunction was found to be significantly correlated with academic performance in our univariate analysis. In addition, our multivariate analysis shows that psychological well-being, affect balance and academic performance each has a direct effect on overall sleep quality. The relationship between overall sleep quality and psychological well-being is U-shaped, while that between overall sleep quality and affect balance is linear and moderated by psychological well-being. The relationship between overall sleep quality and academic performance is either U-shaped or an inverted-U, depending on the level of psychological well-being, which moderates the relationship. These nonlinear relationships indicate that individuals with the highest levels of psychological well-being are not the best sleepers (in terms of overall sleep quality), neither are the highest academic achievers necessarily the best sleepers.
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Affiliation(s)
- Marc A. Armand
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Federica Biassoni
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Alberto Corrias
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
- College of Alice and Peter Tan, National University of Singapore, Singapore, Singapore
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Du C, Wang W, Hsiao PY, Ludy MJ, Tucker RM. Insufficient Sleep and Poor Sleep Quality Completely Mediate the Relationship between Financial Stress and Dietary Risk among Higher Education Students. Behav Sci (Basel) 2021; 11:bs11050069. [PMID: 34063082 PMCID: PMC8147970 DOI: 10.3390/bs11050069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic worsened financial stress for higher education students in the U.S. Financial stress is associated with poor dietary behaviors; however, factors that might influence this relationship are not well characterized. The present cross-sectional study investigated the associations between financial stress and dietary intake and dietary risk scores among higher education students (undergraduate and graduate students) in the U.S. and examined whether poor sleep quality and short sleep duration mediated the relationship between financial stress and dietary risk score. Validated tools were used to assess financial stress, sleep quality, sleep duration, dietary intake, and dietary risk. A total of 1280 students from three large U.S. universities completed the study. Results indicated that higher financial stress was associated with lower vegetable, fruit, fiber, and calcium intake, higher added sugar intake from sugar sweetened beverages, and higher dietary risk score. Further, the positive relationship between financial stress and dietary risk score was completely mediated by poor sleep quality among students who reported poor sleep quality and by short sleep duration among students who slept less than 7 h per night. These findings suggest that students might benefit from both financial management training and sleep education services to reduce undesirable dietary behaviors.
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Affiliation(s)
- Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (W.W.)
| | - Wenyan Wang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (W.W.)
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Mary-Jon Ludy
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Robin M. Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (W.W.)
- Correspondence: ; Tel.: +1-517-353-3408
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Du C, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Hsiao R, Keaver L, Lai CC, Lee H, Ludy MJ, Shen W, Swee WCS, Thrivikraman J, Tseng KW, Tseng WC, Almotwa J, Feldpausch CE, Folk SYL, Gadd S, Wang L, Wang W, Zhang X, Tucker RM. Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk. Clocks Sleep 2021; 3:12-30. [PMID: 33467418 PMCID: PMC7838912 DOI: 10.3390/clockssleep3010002] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 12/11/2022] Open
Abstract
Health behaviors of higher education students can be negatively influenced by stressful events. The global COVID-19 pandemic presents a unique opportunity to characterize and compare health behaviors across multiple countries and to examine how these behaviors are shaped by the pandemic experience. Undergraduate and graduate students enrolled in universities in China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands and the United States (USA) were recruited into this cross-sectional study. Eligible students filled out an online survey comprised of validated tools for assessing sleep quality and duration, dietary risk, alcohol misuse and physical activity between late April and the end of May 2020. Health behaviors were fairly consistent across countries, and all countries reported poor sleep quality. However, during the survey period, the COVID-19 pandemic influenced the health behaviors of students in European countries and the USA more negatively than Asian countries, which could be attributed to the differences in pandemic time course and caseloads. Students who experienced a decline in sleep quality during the COVID-19 pandemic had higher dietary risk scores than students who did not experience a change in sleep quality (p = 0.001). Improved sleep quality was associated with less sitting time (p = 0.010). Addressing sleep issues among higher education students is a pressing concern, especially during stressful events. These results support the importance of making education and behavior-based sleep programming available for higher education students in order to benefit students' overall health.
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Affiliation(s)
- Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Megan Chong Hueh Zan
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Min Jung Cho
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.)
| | - Jenifer I. Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Richard Hsiao
- Department of Kinesiology, Health, and Sport Science, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Laura Keaver
- Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland;
| | - Chang-Chi Lai
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - HeeSoon Lee
- Department of Human Services, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Mary-Jon Ludy
- Department of Public & Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Wan Shen
- Department of Public & Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Winnie Chee Siew Swee
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Jyothi Thrivikraman
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.)
| | - Kuo-Wei Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - Wei-Chin Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - Juman Almotwa
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Clare E. Feldpausch
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Sara Yi Ling Folk
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Suzannah Gadd
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Linyutong Wang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Wenyan Wang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Xinyi Zhang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Robin M. Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
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Kara B. Determinants of perceived stress in health professional students during the COVID-19 pandemic. AIMS MEDICAL SCIENCE 2021. [DOI: 10.3934/medsci.2021014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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