Association between Mental Health Knowledge Level and Depressive Symptoms among Chinese College Students

Path analysis reveals cross-country differences between Czech and Chinese university students in effect of internet and smartphone addiction, mental health, and personality traits on academic achievement in the post-pandemic era

Despite extensive evidence on the impact of various mental health issues including smartphone/internet addiction, and personality traits on academic achievement, little is known about the complex interactions between multiple of these factors simultaneously, as well as cross-country differences in these nuanced relationships. In particular, understanding the role of the mentioned addictions has become increasingly important in recent years in the context of the COVID-19 pandemic. The aim of this cross-country study was to investigate, using path analysis, the complex relationships between mental health determinants (depression, anxiety, stress, resilience, and smartphone/internet addiction) and academic achievement in 1785 Czech and Chinese university students using an online battery of psychological tests. The results confirmed the previously described effect of multiple factors (anxiety, stress, resilience, smartphone/internet addiction, personality traits, and sex, Extraversion, Agreeableness, Conscientiousness) on academic achievement, overlapping in most cases for both groups of students. At the same time, however, different country-dependent patterns of interactions emerged. For the Czech students, the variables formed a complex network of interacting factors, whereas for the Chinese students, the effect of each cluster of factors was separate for individual domains of academic achievement. These cross-country differences have implications particularly for planning and targeting the most effective interventions to promote and develop academic achievement.

Low mental health literacy is associated with depression and anxiety among adults: a population-based survey of 16,715 adults in China

BACKGROUND

Mental health literacy is a predictor of health outcomes in psychological distress. However, limited research has explored whether low mental health literacy is associated with recent depression and anxiety.

METHODS

We used data from the Guangdong Mental Health Survey, a provincial representative and a population-based survey with a multistage stratified cluster random sampling method. We included adults aged 18 and above living in communities from September to December 2021 in Guangdong, China. Eligible participants were those who completed the mental health literacy questionnaire and assessments for depression and anxiety symptoms. We assessed the proportion of individuals with low mental health literacy by categories of psychological symptoms and whether low mental health literacy was associated with depressive and anxiety symptoms in the general population and subgroups.

RESULTS

A total of 16,715 adults were included. We found that individuals with more severe symptoms had a greater proportion of low mental health literacy- it went from 89.4% in participants without depression or anxiety to 96.2% in people who co-occurred with depression and anxiety (x2 = 21.457, P < 0.001). After controlling confounders, low mental health literacy was associated with depression (adjusted Odds Ratio, aOR [95%CI]:2.74 [1.92-4.04]) and anxiety (2.27 [1.49-3.64]) in the total sample, when compared with adequate mental health literacy.

CONCLUSIONS

This study found a positive association between low mental health literacy and the presence of depression and anxiety. Tackling inadequate mental health literacy may be a key strategy to promote psychological well-being across the lifespan, especially for young adults.

Knowledge, attitude, and practice of depression among university students

INTRODUCTION

This study aimed to investigate the knowledge, attitude, and practice (KAP) of depression among university students.

METHODS

A cross-sectional survey was carried out across randomly selected universities in Shandong Province from October 25, 2023, to November 8, 2023. Demographic information and KAP scores were assessed through the administration of questionnaires. The reliability of the questionnaire was confirmed with a Cronbach's alpha coefficient of 0.816 and the Kaiser-Meyer-Olkin measure of 0.894.

RESULTS

This study included 2448 university students, with 1489 (60.8%) females. The median scores for KAP were 20 (Interquartile Range (IQR): 17-21), 26 (IQR: 23-28), and 35 (IQR: 32-38), respectively. Multivariate regression analysis indicated that being a junior (odds ratio [OR] = 0.720, 95% Confidence Interval (CI): 0.538-0.965, p = .028), senior or above (OR = 0.474, 95% CI: 0.325-0.691, p < .001), having divorced parents (OR = 0.618, 95% CI: 0.409-0.933, p = .022), having direct relatives with depression (OR = 0.710, 95% CI: 0.589-0.856, p < .001), and lacking intimate friends (OR = 0.344, 95% CI: 0.245-0.484, p < .001) were negatively associated with practice. Only having an attitude score of ≥26 (OR = 5.076, 95% CI: 4.230-6.091, p < .001) was significantly and positively associated with practice.

CONCLUSION

University students had insufficient knowledge, positive attitude, and passive practice toward depression. Clinical interventions should focus on enhancing the understanding and management of depression among university students, particularly through targeted educational programs and support groups, to bridge the gap between knowledge and practice and foster a proactive approach to mental health care.

The relationship between health-promoting behaviors and negative emotions in college freshmen: a cross-lagged analysis

Background

The prevalence of mental health issues has been gradually increasing among college students in recent years. Improvements in mental health can be achieved through changes in daily behavior and the use of psychological counseling. This study aims to investigate the relationship between health-promoting behaviors and negative emotions among college freshmen as they enter the university. It also examines the impact of various sub-dimensions of health-promoting behaviors and other factors on the negative emotions (stress, anxiety, and depression) experienced by college freshmen.

Methods

Using the Negative Emotion and Health-Promoting Behavior scales, a 7-month longitudinal study was conducted on 4,252 college freshmen, with collection of data at two time points (T1: November 12, 2021; T2: June 17, 2022). Out of this longitudinal study, 3,632 valid samples were obtained. This research aimed to explore the association and impact between negative emotions and the level of health-promoting behaviors among college students during their time at the university.

Results

① There were significant differences in the levels of health-promoting behaviors and negative emotions over the course of 7 months (P < 0.05). Health-promoting behaviors were found to have a significant negative correlation with negative emotions (P < 0.05). ② Negative emotions at T1 significantly negatively predicted health-promoting behaviors at T2 (β = -0.11, P < 0.01), while health-promoting behaviors at T1 significantly negatively predicted negative emotions at T2 (β = -0.12, P < 0.001). ③ Stress management (β = -0.104, P < 0.05; β = -0.087, P < 0.05), self-actualization (β = -0.282, P < 0.01; β = -0.260, P < 0.05), health responsibility (β = -0.057, P < 0.05; β = -0.088, P < 0.05), and interpersonal relations (β = 0.068, P < 0.01; β = 0.138, P < 0.05) were important components in improving stress and anxiety. Self-actualization (β = -0.437, P < 0.001), exercise (β = 0.048, P < 0.001), nutrition (β = 0.044, P < 0.001), and interpersonal relations (β = 0.065, P < 0.001) were important components in improving depression. ④ Gender, place of household registration, and whether the individual is the only child were significant factors affecting negative emotions in college freshmen.

Conclusion

The level of health-promoting behaviors is an important indicator for assessing the negative emotional states of college freshmen. Enhancing health-promoting behaviors across various dimensions can help alleviate different types of negative emotions. Gender, place of household registration, and being the only child are significant factors that influence negative emotions.

Mental health literacy and suicidal ideation among Chinese college students: The mediating role of depressive symptoms and anxiety symptoms

BACKGROUND

Mental health literacy (MHL) is essential to mental health. Symptoms of depression and anxiety are significant antecedents and closely related to suicide among college students. Few studies have explored the mediating role of depressive and anxiety symptoms between MHL and suicidal ideation.

METHODS

5578 college students were included in the analysis. The online Wenjuanxing platform was used to collect data from November 2020 to March 2021. The bootstrapping method was used to test the mediating role of depressive and anxiety symptoms in the links between MHL and suicidal ideation.

RESULTS

Approximately 18.8 % of Chinese college students in our study reported having suicidal ideation. MHL exhibited a significant and negative correlation with depressive symptoms, anxiety symptoms, and suicidal ideation, whereas depressive and anxiety symptoms correlated significantly and positively with suicidal ideation. Compared with the lowest MHL quartile, the 3rd and 4th quartiles of MHL were associated with a significantly lower risk of suicidal ideation after adjusting for various confounding factors. Depressive and anxiety symptoms partially mediated the relationship between MHL and suicidal ideation, and the mediating effect of depressive symptoms was significantly greater than that of anxiety symptoms.

LIMITATIONS

This study was a cross-sectional survey. Future longitudinal studies on this relation are needed.

CONCLUSIONS

Depressive and anxiety symptoms mediate the relationship between MHL and suicidal ideation. Comprehensive school-based specific psychological education programs are needed to improve college students' MHL and change their attitudes toward mental health services.

The interplay of personality traits, anxiety, and depression in Chinese college students: a network analysis

Background

Anxiety and depression are among the greatest contributors to the global burden of diseases. The close associations of personality traits with anxiety and depression have been widely described. However, the common practice of sum scores in previous studies limits the understanding of the fine-grained connections between different personality traits and anxiety and depression symptoms and cannot explore and compare the risk or protective effects of personality traits on anxiety and depression symptoms.

Objective

We aimed to determine the fine-grained connections between different personality traits and anxiety and depression symptoms and identify the detrimental or protective effects of different personality traits on anxiety and depression symptoms.

Methods

A total of 536 college students from China were recruited online, and the average age was 19.98 ± 1.11. The Chinese version of the Ten-Item Personality Inventory, Generalized Anxiety Disorder-7, and Patient Health Questionnaire-9 was used to investigate the personality traits and symptoms of anxiety and depression of participants after they understood the purpose and filling method of the survey and signed the informed consent. The demographic characteristics were summarized, and the scale scores were calculated. The network model of personality traits and symptoms of anxiety and depression was constructed, and bridge expected influence (BEI) was measured to evaluate the effect of personality traits on anxiety and depression. The edge accuracy and BEI stability were estimated, and the BEI difference and the edge weight difference were tested.

Results

In the network, 29 edges (indicating partial correlations between variables) bridged the personality community and the anxiety and depression community, among which the strongest correlations were extraversion-fatigue, agreeableness-suicidal ideation, conscientiousness-uncontrollable worry, neuroticism-excessive worry, neuroticism-irritability, and openness-feelings of worthlessness. Neuroticism had the highest positive BEI value (0.32), agreeableness had the highest negative BEI value (-0.27), and the BEI values of neuroticism and agreeableness were significantly different from those of most other nodes (p < 0.05).

Conclusion

There are intricate correlations between personality traits and the symptoms of anxiety and depression in college students. Neuroticism was identified as the most crucial risk trait for depression and anxiety symptoms, while agreeableness was the most central protective trait.

The effect of mobile phone addiction on perceived stress and mediating role of ruminations: Evidence from Chinese and Czech university students

Introduction

The rise in the capabilities of mobile devices and the associated increase in the proportion of time we spend on them has not only positive benefits but also several risks, including mobile phone addiction and its consequences. The complex mechanisms of the impact of this addiction on mental health, especially in a cross-cultural context, however, remain relatively unknown. The aim of this cross-cultural study was to investigate the mediating role of rumination on the association between mobile phone addiction and perceived stress.

Methods

A population of 358 Chinese and 282 Czech university students was tested using a battery of validated psychological tests that included a short version of the Smartphone Addiction Scale, the Ruminative Response Scale, and the Perceived Stress Scale.

Results

The results showed significant cross-cultural differences with Czech students manifesting greater rumination (d = 0.79) and perceived stress (d = 0.42) and Chinese students showing greater mobile phone addiction (d = 1.01). Mediation analyses showed that the effect of mobile phone addiction on stress levels was mediated through the rumination in both populations (45.6% and 80.9% of the explained variance for Chinese and Czech students, respectively) and did not differ between the two countries (estimate of difference [95%CI] = -0.052[-0.166, 0.037], p = 0.27). In contrast, the significant direct effect of mobile phone addiction on perceived stress was only present in Chinese students, where it was marginally larger than the indirect effect. In Czech students, the direct effect was not manifested and the difference between countries was significant (estimate of difference [95%CI] = 0.242 [0.035, 0.413], p < 0.001). In all of the cases, the association between the variables was positive, i.e., as one grew, so did the other. Finally, a moderated-mediation analysis confirmed that country of origin significantly moderated only the direct relationship between mobile phone dependence and perceived stress (p = 0.002).

Discussion

These results suggest that the mechanism of interaction between excessive mobile phone use and perceived stress is culturally conditioned, which may limit the transferability of research findings in a global context and requires further cross-cultural studies.

Lifestyle-related risk factors correlated with mental health problems: A longitudinal observational study among 686 male college students in Chongqing, China

Aim

Public concerns over the mental health problems of college students are rising. Previous research show that female tend to suffer more from mental health problems than males, with few studies focusing on males. This study sought to explore the association of lifestyle-related risk factors with the prevalence of mental health problems among male college students in China.

Methods

The lifestyle information and mental health status of 686 male college students from Chongqing, China, were assessed in 2014, and 582 of them were followed up a year later. Participants completed a questionnaire assessing demographic and lifestyle factors which include sleep quality, computer usage, sedentariness, physical activity, smoking, current alcohol, coke, coffee, and milk tea drinking, and current tea/fried food/baked food consumption. Mental health problems were measured using the Depression Anxiety Stress Scale-21 (DASS-21).

Results

Univariate analyses indicated that age, sleep latency, sleep duration, computer usage time, milk tea drinking, and fried food consumption were potential risk factors for mental health problems (p's < 0.05). Multivariate analysis further revealed that, either at baseline or during follow-up, participants with (i) more computer usage time were at a higher risk of having depression symptoms (p's < 0.05) and (ii) a higher frequency of fried food consumption were associated with a higher risk of having depression, anxiety, and stress symptoms (p's < 0.05). Additionally, the cross-lagged analysis showed that (i) computer usage time in 2014 is positively correlated with depression status (β = 0.106, p < 0.05) but not anxiety (β = 0.047, p > 0.05) and stress (β = 0.019, p > 0.05) status a year later and (ii) fried food consumption in 2014 is positively correlated with depression (β = 0.129, p < 0.01), anxiety (β = 0.168, p < 0.001), and stress (β = 0.113, p < 0.01) status a year later.

Conclusions

Computer usage time and fried food consumption were lifestyle-related risk factors for mental health problems in male college students in Chongqing, China. These results might emphasize further preventive strategies for mental health problems, especially in male college students.

Influencing factors, prediction and prevention of depression in college students: A literature review

The high prevalence of depression among college students has a strong negative impact on individual physical and mental health, academic development, and interpersonal communication. This paper reviewed the extant literature by identifying nonpathological factors related to college students' depression, investigating the methods of predicting depression, and exploring nonpharmaceutical interventions for college students' depression. The influencing factors of college students' depression mainly fell into four categories: biological factors, personality and psychological state, college experience, and lifestyle. The outbreak of coronavirus disease 2019 has exacerbated the severity of depression among college students worldwide and poses grave challenges to the prevention and treatment of depression, given that the coronavirus has spread quickly with high infection rates, and the pandemic has changed the daily routines of college life. To predict and measure mental health, more advanced methods, such as machine algorithms and artificial intelligence, have emerged in recent years apart from the traditional commonly used psychological scales. Regarding nonpharmaceutical prevention measures, both general measures and professional measures for the prevention and treatment of college students' depression were examined in this study. Students who experience depressive disorders need family support and personalized interventions at college, which should also be supplemented by professional interventions such as cognitive behavioral therapy and online therapy. Through this literature review, we insist that the technology of identification, prediction, and prevention of depression among college students based on big data platforms will be extensively used in the future. Higher education institutions should understand the potential risk factors related to college students' depression and make more accurate screening and prevention available with the help of advanced technologies.

The impacts of coping style and perceived social support on the mental health of undergraduate students during the early phases of the COVID-19 pandemic in China: a multicenter survey

BACKGROUND

An increasing number of undergraduate students in China have been reported to have psychological problems. In response to the COVID-19 pandemic, a series of preventive and control measures were implemented, which undoubtedly worsened their psychological health. Coping style and social support were probably important factors that affected the psychological well-being of undergraduate students during the pandemic. This study aimed to explore the effects of coping style and perceived social support on the psychological well-being of college students and relevant risk factors.

METHODS

This cross-sectional study was performed in February and March of 2020 by distributing an online questionnaire among undergraduate students from seven geographical regions across China. The questionnaire included sociodemographic information; the 21-item Depression, Anxiety and Stress Scale (DASS-21); the Perceived Social Support Scale (PSSS); and the Simplified Coping Style Questionnaire (SCSQ). For the analyses, t-tests, one-way analysis of variance (ANOVA), the Kruskal-Wallis test and multiple linear regression were utilized. The level of significance was set at P < 0.05.

RESULTS

Among 3113 college students, the rates of anxiety, depression and stress symptoms were 13.3, 15.4 and 6.8%, respectively. Increased rates of current smoking and drinking (5.5 and 25.2%, respectively) among undergraduates were identified. The results indicated that the PSSS subscales and SCSQ subscales were significantly associated with DASS-21 scores (P < 0.001). Multiple linear regression analysis showed that active coping style and family support were protective factors while passive coping style could aggravate psychological problems among participants (P < 0.001).

CONCLUSIONS

A remarkable number of college students adopted passive coping strategies to cope with negative feelings, such as smoking and drinking, which were detrimental to their mental health. In contrast, active coping strategies helped improve their psychological well-being. Moreover, family support was particularly important for maintaining their mental health and ameliorating mental health challenges in this major health crisis. Consequently, suitable psychointervention, routine screening for risk behaviors, and provision of further social support are needed for undergraduate students in the COVID-19 pandemic or other emergency public health events.

Effects on Heart Rate Variability of Stress Level Responses to the Properties of Indoor Environmental Colors: A Preliminary Study

Color is the most potent stimulating factor affecting human vision, and the environmental color of an indoor space is a spatial component that affects the environmental stress level. As one of the methods of assessing the physiological response of the autonomic nervous system that influences stress, heart rate variability (HRV) has been utilized as a tool for measuring the user’s stress response in color environments. This study aims to identify the effects of the changes of hue, brightness, and saturation in environmental colors on the HRV of two groups with different stress levels—the stress potential group (n = 15) and the healthy group (n = 12)—based on their stress level indicated by the Psychosocial Well-being Index (PWI). The ln(LF), ln(HF), and RMSSD values collected during the subjects’ exposure to 12 environments colors of red and yellow with adjusted saturation and brightness, were statistically analyzed using t-test and two-way ANOVA. The results show that the HRV values in the two groups did not significantly vary in response to the changes in hue, brightness and saturation. The two groups’ stress factors distinguished according to the stress levels by the PWI scale affected the In(LF) parameter, which demonstrates that the PWI index can be utilized as a reliable scale for measuring stress levels. The ultra-short HRV measurement record and the use of a sole In(LF) parameter for stress assessment are regarded as the limitations of this study.

Students' Intention of Visiting Urban Green Spaces after the COVID-19 Lockdown in China

This study addresses students' perceptions of using urban green spaces (UGSs) after the easing of COVID-19 lockdown in China. We questioned whether they are still mindful of the risks from the outdoor gathering, or conversely, starting to learn the restoration benefits from the green spaces. Online self-reported surveys were distributed to the Chinese students aging from 14 to 30 who study in Hunan and Jiangsu Provinces, China. We finally obtained 608 complete and valid questionnaire forms from all participants. Their intentions of visiting UGSs were investigated based on the extended theory of planned behavior model. Structural equation modeling was employed to test the hypothesized psychological model. The results have shown good estimation performance on risk perception and perceived knowledge to explain the variances in their attitudes, social norms, and perceived behavior control. Among these three endogenous variables, the perceived behavior control owns the greatest and positive influence on the behavioral intention, inferring that controllability is crucial for students to make decisions of visiting green spaces in a post-pandemic context.

The Mental Health of German Students During the COVID-19 Pandemic

Abstract. Theoretical background: The COVID-19 pandemic has changed the daily lives of students completely. Studies indicated that psychology students may be less stressed during the pandemic than other students. This study compares psychology students and students from other disciplines regarding their mental health, alcohol consumption, and partnerships after the third wave of the COVID-19 pandemic. Methods: The study sample consisted of n = 127 psychology students and n = 579 students from other disciplines at the TU Braunschweig in Germany who participated in an online survey in June / July of 2021. To analyze the differences between the psychology students and students from other disciplines after the third wave, we calculated t-tests, Chi²-tests, and U-tests separately for female and male students. Results: Significantly fewer female psychology students were above the cut-off values for clinically relevant depressive symptoms (31.5 %; p  < .001, Cramer’s  V = .32) and anxiety symptoms (22.2 %; p < .001, Cramer’s V = .27) than other female students (depressive symptoms: 66.1 %; anxiety symptoms: 41.9 %). The small sample of male psychology students showed similar tendencies. While female psychology students rated their general health and life satisfaction higher than other female students, male psychology students were less concerned about their professional future than their respective counterparts. No differences were found concerning alcohol consumption and partnerships. Conclusion: We found indications that psychology students, especially female students, are less psychologically distressed after the third wave than students from other disciplines. Better mental health knowledge could be an explanation for this.