Effects of COVID-19 on College Students' Mental Health in the United States: Interview Survey Study

Mental health, coping strategies, and social support among international students at a Canadian university

Objective. This study aimed to explore the mental health status, coping strategies, and social support of international students in Canada. Participants. Undergraduate and graduate international students studying at one Canadian university participated in an online survey. Methods. The survey consisting of four assessments-the Mental Health Continuum-Short Form, Kessler Psychological Distress Scale, the Carver Brief-Cope Inventory, and the Multidimensional Scale of Perceived Social Support-was distributed during the winter and spring terms of 2020. Results. Of the 338 participants from 53 countries, 76% demonstrated optimal mental health without mental disorders; 86% used approach coping strategies. Those who are women, married, and Ph.D. students showed better mental health and lower psychological distress. Coping skills and social support significantly predict participants' psychological distress and subjective well-being. Conclusions. This study findings address the gaps in meeting the mental health needs of international students and raise awareness of this population's unique mental health status.

How are students coping one year after the COVID-19 lockdown? A photoelicitation project

Objective: To understand how students are coping one year after campuses were closed due to the COVID-19 pandemic. Participants: Students at a large state university in Midwestern USA. Method: Sequential mixed method study. A photo-survey of students' experiences was conducted as part of an ethnographic study of "college life." Student researchers and faculty collaboratively analyzed photos and accompanying text for coping strategies. Association of coping strategies with respondents' characteristics was assessed with inferential statistics. Results: Most respondents alluded to the negative mental toll of the pandemic and predominantly utilized emotion-focused coping strategies. Non-binary students and students who lived off but close to campus appeared to have fewer coping strategies than their peers. Conclusion: The experiences of diverse student sub-populations differ. Photos give researchers a unique vista into students' experiences. Students - as co-researchers - can help campuses understand the stresses associated with their college experiences and how they are coping.

Exploring graduate student mental health and service utilization by gender, race, and year in school

OBJECTIVE

The current study explored differences in mental health problems, services utilization, and support of graduate students by gender, race/ethnicity, and year in school.

PARTICIPANTS

Participants consisted of 734 graduate students from a large, Midwestern university.

METHODS

Graduate students answered a series of questionnaires in fall 2021 assessing their mental health, services utilization, and perception of services.

RESULTS

Women (vs men) and participants in their second year and beyond (vs first year) reported greater mental health problems, negative impact of the pandemic, and more services utilization. White (vs non-White) participants reported greater negative impact of the pandemic, greater services utilization, and less financial strain. Finances, lack of knowledge about resources, and inadequate communication from the university about services were reported as treatment barriers.

CONCLUSION

Graduate students struggle with mental health, and universities may need to improve communication with and tailor their services to graduate students specifically to better support them.

Sleep health, its intraindividuality, and perceived stress in college students during the COVID-19 pandemic

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.

Psychometric Properties of Scores on the Mental Distress Response Scale among First-Generation College Students: Implications for Retention

First-generation college students" (FGCS) are at risk for suffering from mental health issues, which have direct implication for their retention and academic success. Past investigators consistently find that college students are more likely to discuss mental health issues with their peers than with college personnel. The first step in peer-to-peer mental health support is screening students on campus to gain a baseline understanding of how they respond when encountering a peer in mental distress. The Mental Distress Response Scale (MDRS) is a screening tool for appraising students" responses to a peer in mental distress. Score validation is a crucial step, as FGCS are a unique college student population and the psychometric properties of instrumentation can vary between different populations. Psychometric testing yielded support for the validity of scores on the MDRS with FGCS. Findings have direct implications for aiding student affairs officials" universal screening efforts to support FGCS" mental health and retention.

Exploring Reddit conversations about mental health difficulties among college students during the COVID-19 pandemic

Objective: We aimed to explore conversations about mental health difficulties by Reddit users who posted within college subreddits during the COVID-19 pandemic. Participants: Data were collected from the subreddits of 22 California campuses, representing 113,579 anonymous members. Using the following search terms, we retrieved 577 posts (ie, 268 original posts and 309 replies): COVID, Coronavirus, Quarantine, Pandemic, Anxiety, Anxious, Depressed, Depression, Overwhelmed, Stress, and Stressed. Methods: We used inductive, thematic data analysis to explore themes within posts and replies dated from 3/16/2020 to 3/16/2021. Results: We identified the following themes: 1) the COVID-19 pandemic has negatively impacted engagement with learning; 2) remote learning has exacerbated students' mental health difficulties; and 3) students provide and receive social support online. Conclusions: These findings have implications that are particularly relevant as campuses are faced with continuous decisions related to repopulation.

Wearable neurofeedback acceptance model for students' stress and anxiety management in academic settings

This study investigates the technology acceptance of a proposed multimodal wearable sensing framework, named mSense, within the context of non-invasive real-time neurofeedback for student stress and anxiety management. The COVID-19 pandemic has intensified mental health challenges, particularly for students. Non-invasive techniques, such as wearable biofeedback and neurofeedback devices, are suggested as potential solutions. To explore the acceptance and intention to use such innovative devices, this research applies the Technology Acceptance Model (TAM), based on the co-creation approach. An online survey was conducted with 106 participants, including higher education students, health researchers, medical professionals, and software developers. The TAM key constructs (usage attitude, perceived usefulness, perceived ease of use, and intention to use) were validated through statistical analysis, including Partial Least Square-Structural Equation Modeling. Additionally, qualitative analysis of open-ended survey responses was performed. Results confirm the acceptance of the mSense framework for neurofeedback-based stress and anxiety management. The study contributes valuable insights into factors influencing user intention to use multimodal wearable devices in educational settings. The findings have theoretical implications for technology acceptance and practical implications for extending the usage of innovative sensors in clinical and educational environments, thereby supporting both physical and mental health.

Mapping the Evolution of Digital Health Research: Bibliometric Overview of Research Hotspots, Trends, and Collaboration of Publications in JMIR (1999-2024)

BACKGROUND

While bibliometric studies of individual journals have been conducted, to the best of our knowledge, bibliometric mapping has not yet been utilized to analyze the literature published by the Journal of Medical Internet Research (JMIR).

OBJECTIVE

In celebration of the journal's 25th anniversary, this study aimed to review the entire collection of JMIR publications from 1999 to 2024 and provide a comprehensive overview of the main publication characteristics.

METHODS

This study included papers published in JMIR during the 25-year period from 1999 to 2024. The data were analyzed using CiteSpace, VOSviewer, and the "Bibliometrix" package in R. Through descriptive bibliometrics, we examined the dynamics and trend patterns of JMIR literature production and identified the most prolific authors, papers, institutions, and countries. Bibliometric maps were used to visualize the content of published articles and to identify the most prominent research terms and topics, along with their evolution. A bibliometric network map was constructed to determine the hot research topics over the past 25 years.

RESULTS

This study revealed positive trends in literature production, with both the total number of publications and the average number of citations increasing over the years. And the global COVID-19 pandemic induced an explosive rise in the number of publications in JMIR. The most productive institutions were predominantly from the United States, which ranked highest in successful publications within the journal. The editor-in-chief of JMIR was identified as a pioneer in this field. The thematic analysis indicated that the most prolific topics aligned with the primary aims and scope of the journal. Currently and in the foreseeable future, the main themes of JMIR include "artificial intelligence," "patient empowerment," and "victimization."

CONCLUSIONS

This bibliometric study highlighted significant contributions to digital health by identifying key research trends, themes, influential authors, and collaborations. The findings underscore the necessity to enhance publications from developing countries, improve gender diversity among authors, and expand the range of research topics explored in the journal.

An Assessment of Mental Health Challenges of Lesbian, Gay, Bisexual, and Transgender College Students during the COVID-19 Pandemic

INTRODUCTION

Collegiate mental health continues to be a worrisome public health concern among college students in the U.S. The unprecedented COVID-19 pandemic has caused an upward trend of mental health crises, especially among lesbian, gay, bisexual, and transgender (LGBTQ+) college students. The objective of this study was to assess the mental health statuses, attitudes towards disease control and mitigation measures, and coping strategies among this vulnerable group.

METHODS

A web-based survey was conducted at a medium-sized public university in the mid-Atlantic region during the summer and fall of 2021 when COVID-19 was still a major public health concern. The survey was distributed through the listservs of the college and was advertised through campus-wide social media. Descriptive and inferential statistics including a t-test for the differences in group means and a logit regression model for comparing the groups were used.

RESULTS

Our final sample is composed of 611 students with 79% of the respondents identifying as straight, and 20% in the LGBTQ+ group. Our results showed that LGBTQ+ students exhibited higher levels of anxiety and fear compared to the non-LGBTQ+ groups. Also, a large proportion of LGBTQ+ students were negatively impacted by the pandemic as compared to the non-LGBTQ+ groups (p = 0.05), while they generally have more positive views on the public health measures to alleviate the adverse impacts from COVID-19 (p = 0.001).

CONCLUSIONS

Public health emergency management should adopt appropriate strategies and adapt their services to support the mental health needs of LGBTQ+ students. Our study highlighted the need to design tailored health promotion programs and enhance support systems for LGBTQ+ college students during similar emergencies.

Developing a cyberchondria severity scale to promote self-care among university students during COVID-19

Cyberchondria is a hybrid term signifying a state in which individuals compulsively search for health-related information online because of health distress or anxiety, further aggravating their worries. This study develops a Cyberchondria Severity Scale (CSS) to assess the current situation of university students. Exploratory factor analysis (EFA) was conducted using 145 valid questionnaires. Subsequently, a nationwide survey was conducted at various universities in Taiwan, and 802 questionnaires were used for confirmatory factor analysis (CFA). The EFA led to the development of a CSS for college students with four constructs: increased anxiety (α = 0.91), obsessive-compulsive hypochondria (α = 0.87), perceived controllability (α = 0.88), and online physician-patient interaction (α = 0.86), with a Cronbach's alpha of 0.92 and variance of 66.81%. The CFA indicated that item reliability ranged from 0.50 to 0.86, factor loadings ranged from 0.71 to 0.93, and the composite reliability for latent variables ranged from 0.83 to 0.90 (p < .001). The extracted average variance ranged from 0.46 to 0.60. There were significant differences in various dimensions: perceived controllability had the highest score and obsessive-compulsive hypochondria had the lowest (F3,2403=256.26, p < .001). Therefore, CSS has emerged as a reliable and valid measure. Future studies should explore the factors that influence cyberchondria, promote online health information searches, and enhance reading comprehension skills.

Comparative Outcomes of a Cognitive-Behavioral Skills Building Program on the Mental Health and Healthy Behaviors of Prenursing Students

BACKGROUND

Nursing students experience significantly more stress related diseases when compared to non-nursing students, and the state of their mental health can result in short-term increased attrition rates and increased nursing shortages.

PURPOSE

A preexperimental pre-post study design was used to examine mental health and healthy behaviors among prenursing students.

METHODS

Cohorts received the MINDSTRONG© program either in-person or virtually. Data analysis included Personal Wellness Assessments completed at both pre- and poststudy for all participants (n = 110).

RESULTS

Both groups postintervention had statistically significant decreases in anxiety, depression, and stress and statistically significant increases in healthy lifestyle behaviors and beliefs. Students with elevated depression and anxiety scores at baseline had greater decreases postintervention than the overall groups.

CONCLUSION

The outcomes for both cohorts were positive and effective in reducing stress, anxiety, and depressive symptoms. Healthy behaviors were improved and align with findings with an in-person format. Findings from this study support implementation of MINDSTRONG in synchronous sessions, either in-person or virtual.

Mental health support for Canadian postsecondary students during COVID-19 pandemic: An environmental scan

OBJECTIVE

This study explored how Canada's postsecondary institutions have informed students about campus mental health (MH) services via websites and social media during the COVID-19 pandemic.

METHODS

We conducted a Web-based environmental scan of 20 universities and 24 colleges across the province of Ontario, Canada, between October 2020 and July 2021.

RESULTS

91% of the institutions offered virtual counseling services and 84% offered general psychoeducational resources, whereas only 55% had COVID-19 specific MH resources. Larger institutions had more MH support to students than small schools. There was a trend toward outsourcing counseling and emergency services to external professionals via apps and hotlines. Limited MH information was available for out-of-province and international students.

CONCLUSION

It is vital for equitable campus MH services to address unique MH challenges associated with the crisis and intentional outreach to students with special circumstances. Schools can leverage peer support and self-help to promote student mental well-being.

Promoting a health-centered approach to acute mental health crises on college campuses: The case for collegiate-based emergency medical services

As college and university campuses re-open during the COVID-19 pandemic, there is increased concern for mental health crises. Current trends in campus mental health care emphasize providing quality care in a safe, non-judgmental, and non-punitive manner. Collegiate-based emergency medical services organizations are well-positioned to respond to acute mental health crises on college campuses. Campus health professionals and administrators seeking to promote a health-centered approach toward mental health crises should support the growth and development of collegiate-based emergency medical services organizations.

Social support and academic experience among higher education students in Israel during the COVID-19 pandemic

This study focused on the implications of the COVID-19 pandemic on the academic experience of university students and their plans for dropping out. We examined how their health, exposure to COVID, and personal COVID-related health risk were associated with perceived social support and a positive academic experience versus plans to drop out of academic studies. We questioned 10,635 students from six research universities in Israel in a cross-sectional online survey. Our findings confirmed that exposure to COVID-19 was positively associated with perceived social support and plans to drop out of academic studies, but negatively associated with a positive academic experience. The greater the perceived social support, the more positive the academic experience, with fewer plans to drop out academically. The more negative students' perceptions of their general health, the more frequent the plans to drop out of academic studies. Also, perceived social support and a positive academic experience mediated the associations between COVID-19 exposure and health status, and plans to drop out of academic studies. This study highlights the potentially positive role of social support and positive academic experiences as significant resources and potential protective factors against plans brought on by COVID to drop out of academic studies.

The longitudinal mediating role of sleep in associations between COVID-19 stressors predicting mental and physical health outcomes among emerging adult college students

The current study tested a longitudinal mediation model throughout the COVID-19 pandemic focused on whether students' housing instability stress and food/financial instability stress at the beginning of the pandemic in spring 2020 (T1) informed sleep dissatisfaction and duration in fall 2020 (T2) and, in turn, physical and mental health in spring 2021 (T3). Further, we tested whether relations varied based on students' ethnic-racial backgrounds. Participants included 879 Asian, Black, Latine, Multiracial, and White emerging adult college students (Mage = 19.95, SD = 0.33) from a large public university in the mid-Atlantic region of the United States who attended college during the COVID-19 pandemic and completed surveys about their experiences. Findings indicated a significant mediation process, such that T1 housing instability stress predicted greater T2 sleep dissatisfaction and, in turn, less physical health, greater depressive symptoms, and greater anxiety symptoms at T3. Additionally, T1 food/financial instability stress was significantly associated with less T2 sleep duration but was not, in turn, associated with any T3 outcomes. Findings did not vary by students' ethnicity/race. Results highlight that sleep dissatisfaction is an important factor that accounts for relations between COVID-19 stressors predicting mental and physical health outcomes throughout the pandemic.

Differences between College Males and Females' Coping Mechanisms in Relation to the COVID-19 Pandemic

This study's purpose is to examine the differences between how men and women use cognitive coping mechanisms in stressful situations, specifically the COVID-19 pandemic. Research suggests that men and women cope with stress differently. Women tend to have a more emotional response to stressors and are expected to spend more time discussing issues with family and friends. Men are socialized for problem-focused coping. Only using problem-focused coping can be problematic when the cause of the stress cannot be changed by the individual. A secondary goal of this study was to evaluate other factors that affected cognitive coping, such as knowing someone who died of COVID-19. Participants ages 18-24 were invited to take part in an online survey evaluating cognitive coping mechanisms. After analysis, we found that in many ways men and women cognitively coped similarly. More often, women use a wider range of coping strategies except for self-blame and other blame. The participants used the coping mechanisms at significantly higher levels than adults during pre-pandemic times. Knowing someone who died of COVID-19 correlated with statistically significantly higher usage of several coping mechanisms. Understanding young adults' cognitive coping during high-stress scenarios can uncover solutions to improved mental health care.

Non-consensual Sex Among Japanese Women in the COVID-19 Pandemic: A Large-Scale Nationwide Survey-Based Study

Introduction and background Non-consensual sex, including rape and sexual assault, has been a global concern and may have been influenced by the COVID-19 pandemic. However, information on this topic is limited. Therefore, our objective was to survey the incidence rate of non-consensual sex among Japanese women aged 15-79 years between April and September 2020, during the early stages of the COVID-19 pandemic in Japan. Materials and methods We utilized data from a sample of approximately 2.2 million individuals who participated in a web-based self-reported questionnaire survey from a nationwide, cross-sectional internet survey conducted in Japan between August and September 2020. Sampling weights were applied to calculate national estimates, and multivariable logistic regression was performed to identify factors associated with non-consensual sex. Data were extracted from a web-based, self-administered survey of approximately 2.2 million individuals. Results The study examined the incidence of non-consensual sex among 12,809 women with valid responses, finding an overall rate of 1.1% across all participants. Higher rates were observed among women aged 20-29 (2.4%) and employed women (1.5%) compared to unemployed women (0.7%). No significant difference was noted based on living areas. Increased FCV-19S scores, worsening or improving mental health before COVID-19, suicidal thoughts, and feelings of isolation were all linked to higher incidence rates. Non-payment of salary and lack of money for necessities also correlated with higher rates. Key risk factors included age 15-19 or 20-29, employment, financial instability, suicidal thoughts, and isolation. Notably, 20% of women aged 15-19 reported suicidal ideation. Conclusions This study underscores the critical need for mental and financial support for young women, highlighting the importance of early intervention for economically vulnerable groups. Comprehensive education on sexual consent is essential, especially during societal upheavals like the COVID-19 pandemic, to prevent non-consensual sex and support affected individuals.

Mask wearing and self-harming thoughts among international students in the United States during COVID-19: The moderating role of discrimination

Objective: This study examined associations among discrimination, mask-wearing behavior, and self-harming thoughts among international students in the United States during COVID-19. Participants: Undergraduate and graduate international students enrolled in universities during the 2020 summer semester participated in the online survey (N = 103). Methods: Perceived discrimination, mask-wearing behavior, and self-harming thoughts during COVID-19 were assessed by self-reports. Multivariable logistic regressions examined the association among discrimination, mask-wearing behavior, and self-harming thoughts and explored the potential moderation effect of discrimination on the association between mask-wearing and self-harming thoughts. Results: 18.6% of participants reported self-harming thoughts. Increased discrimination was significantly associated with increased odds of self-harming thoughts. Discrimination significantly moderated the association between mask wearing and self-harming thoughts. Conclusions: The findings highlight the importance of increased availability of culturally appropriate mental health services for international students and the need for increased advocacy to decrease discrimination against international students in the current societal context.

Mental health of international students in the United States during the COVID-19 pandemic and its relevant political climate: A descriptive cross-sectional study

Objective: To address the impact of the COVID-19 pandemic and its relevant political climate on college-level international students in the United States. Participants: International students aged 18 years and older in the San Francisco Bay Area. Methods: A descriptive cross-sectional survey using PHQ-9 and the GAD-7. Results: The prevalence of depression and anxiety significantly decreased during the last two weeks from the survey completion in April or May in 2021 (Time 2) as compared to the two weeks after the July 6th policy directive in 2020 (Time 1). However, both depression severity, 2.172 (95% CI: 1.900, 2.445), and anxiety severity, 1.897 (95% CI: 1.655, 2.138), during Time 2 were still mild, indicating the ongoing COVID-19 pandemic had still negatively impacted their mental health status. Conclusions: Future research can expand the target population and analyze the long-term effects of policy changes and disease outbreaks on international students in the United States.

Sleep Disturbances in Health Professional Students During the COVID-19 Pandemic: A Concept Analysis

AIM

The aim is to delineate the concept of sleep disturbances in health professional students during the COVID-19 pandemic.

DESIGN

A concept analysis was conducted.

METHODS

A systematic search was conducted for relevant articles published and performed from inception to July 5, 2024. Electronic databases searched included PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Web of Science. Rodgers' method of evolutionary concept analysis was used.

RESULTS

A total of 50 pertinent articles were included in our analysis. Utilising inductive thematic analysis, this study identified attributes, antecedents and consequences of sleep disturbances. Important attributes included insomnia, disrupted sleep patterns, altered sleep duration/nocturnal sleep duration and poor sleep quality. Antecedents encompassed factors such as gender, age/grade levels, physical activity, screen time of digital production, mental health issues, COVID-19-related stressors, financial strain and academic stress. Consequences included both mental and physical health implications. By addressing sleep disturbances and promoting better sleep health among students, we can enhance their learning and performance, which could translate to improved patient care outcomes. Additionally, understanding and mitigating sleep disturbances can contribute to the development of a more resilient and effective health care workforce, capable of providing high-quality care even during crises like the COVID-19 pandemic.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Coping with COVID-19: a prospective cohort study on young Australians' anxiety and depression symptoms from 2020-2021

BACKGROUND

Studies have shown that the coronavirus (COVID-19) pandemic negatively impacted the mental health of young Australians. However, there is limited longitudinal research exploring how individual factors and COVID-19 related public-health restrictions influenced mental health in young people over the acute phase of the COVID-19 pandemic. This study aimed to identify risk and protective factors associated with changes in individual symptoms of anxiety and depression among young Australians during the COVID-19 pandemic.

METHODS

This prospective cohort study collected data on anxiety and depression symptoms of young Australians aged 15-29 years old using the Depression, Anxiety and Stress Scale short form (DASS-21). We delivered four online questionnaires from April 2020 to August 2021 at intervals of 3, 6, and 12 months after the initial survey. We implemented linear mixed-effects regression models to determine the association among demographic, socioeconomic, lifestyle and COVID-19 public health restrictions related factors and the severity of anxiety and depression symptoms over time.

RESULTS

Analyses included 1936 young Australians eligible at baseline. There was a slight increase in DASS-21 anxiety mean scores from timepoint 3 to timepoint 4. DASS-21 depression scores showed slight fluctuations across timepoints with the highest mean score observed in timepoint 2. Factors associated with increases in anxiety and depression severity symptoms included LGBTQIA + identity, financial insecurity both before and during the pandemic, higher levels of loneliness, withdrawal or deferral of studies, spending more time on social media, and difficulties to sleep. Risk factors for only depression symptoms include unemployment during COVID-19 pandemic and being in lockdown. Living with someone was a protective factor for both anxiety and depression symptoms, pre-COVID-19 unemployment for depression symptoms, and older age and unemployment during the pandemic for anxiety symptoms.

CONCLUSION

These findings indicate that during the first year of the pandemic in Australia, there were significant changes in young people's mental health which were associated with multiple demographic, socioeconomic, lifestyle, and lockdown factors. Hence, in future public health crises, we suggest more inclusive guidelines that involve young people in their development and implementation ensuring that their unique perspectives and needs are adequately considered.

Cognitive distortions as a mediator of the relationship between dispositional mindfulness and psychological distress among college students

OBJECTIVE

This study examined the mediating role of cognitive distortions (CDs) in the relationship between dispositional mindfulness (DM) and psychological distress, and considered gender as a potential moderator of these mediation models.

PARTICIPANTS

Four hundred and forty-six college students (63.9% female; M = 20.52 years; 87.4% undergraduate, 12.6% graduate level) participated.

METHODS

Self-report measures of DM, CDs, anxiety, depression, and perceived stress were completed with data collected from April to October of 2020.

RESULTS

Females scored significantly higher than males on anxiety, depression, perceived stress, and CDs. CDs partially mediated the relationship between DM and all psychological distress variables. Gender moderated the mediation model predicting anxiety, with the indirect effect of DM on anxiety via CDs being stronger for females than males.

CONCLUSION

Results support CDs as a possible mechanism underlying the association between DM and psychological distress with implications for targeting cognitive patterns in mindfulness-based interventions with college students.

Depressive and anxiety symptoms among university students during the later stages of the COVID-19 pandemic in Germany - Results from the COVID 19 German Student Well-being Study (C19 GSWS)

Introduction

Data on the mental health of university students in Germany during the later stages of the pandemic is still limited. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 1.5 years after the first COVID-19 restrictions and (2) which factors were associated with these outcomes.

Methods

The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 6,996 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analyzed using multivariable logistic regression models.

Results

The mean age of the participants was 23.9 years (SD = 4.8), 67% were female and 31% male. The prevalence for depressive symptoms was 29 and 32% for anxiety. The lack of a trusted person and financial difficulties were associated with anxiety and depressive symptoms. Being worried that someone in one's personal network had become severely ill with COVID-19 and concern about (re)infection with COVID-19 were associated with anxiety symptoms. Those with pre-existing health conditions had an up to 1.98-times higher chance for reporting depressive symptoms (OR, 95% CI: 1.01-3.88) and an up to 2.27-times higher chance for anxiety symptoms, respectively (OR, 95% CI: 1.15-4.46).

Conclusion

Concepts for prevention and counseling to tackle mental health problems in students are needed and programs should take specific stressors in times of crises into account.

Changes in Psychological Challenges, Positive Experiences, and Coping Strategies among International Students in the United States before and during the COVID-19 Pandemic: A Qualitative Study

The purpose of this study was to understand how the challenges and coping strategies among international students in the United States changed before and during the COVID-19 pandemic. We conducted a qualitative study through one-on-one in-depth interviews during April-June 2021. A total of 34 international students in the San Francisco Bay Area participated in this study. NVivo was used to analyze the qualitative data. Before COVID-19, the challenges were primarily related to a sense of belonging, such as culture shock, language barriers, and loss of identity. However, some positive experiences from school life and new culture were also found before COVID-19. During the pandemic, students faced difficulties with online learning and lockdown protocols that they had never experienced before. The ongoing challenges before and during COVID-19 were identity crisis, racism and discrimination, and financial struggles. Common coping strategies for overcoming these difficulties included engaging in physical activity, social exposure, self-improvement, and mental self-care. The frequency of online engagement and motivation for self-improvement were particularly highlighted during COVID-19. However, international students expressed a preference for improved support systems, including financial aid, paid research opportunities, and more accessible campus resources. Future research could focus on the strategies to support the psychological well-being of international students in coping with unexpected situations, such as disease outbreaks.

Academic and non-academic predictors of common mental health difficulties among university students during the COVID-19 pandemic

Introduction

Public concern for the mental health of university students has been rising over recent years. Newly arising stressors associated with the COVID-19 pandemic could contribute to further mental health burden for students. This study aimed to understand the mental health status of university students at an early stage in the pandemic and to identify academic, non-academic, and COVID-19-related predictors of common mental health difficulties at this time.

Methods

This study examined how academic and non-academic predictors relate to common mental health difficulties using a cross-sectional sample of university students (n = 3817).

Results

There were high levels of depression and anxiety during the pandemic, with more than 50% experiencing levels above the clinical cut offs. Academic stress, social isolation, intolerance of uncertainty, and more negative attitudes towards remote teaching and learning predicted higher levels of depression and anxiety. University identification predicted lower levels of depression whereas receiving a diagnosis of COVID-19 was associated with higher levels of depression.

Discussion

This study identified COVID-19-related factors that uniquely contributed to students' distress during the pandemic, over and above social connectivity variables. As COVID-19 factors, such as the uncertainty surrounding the pandemic, may have driven an increase in distress levels among students, these findings provide insights that could help universities and policymakers develop targeted interventions to support the mental health and well-being of university students during future crises.

Coping Mechanisms and Posttraumatic Stress Exhibited by Children in Areas of Yemen's Armed Conflict in Southern Saudi Arabia

This study is an attempt to explore war-related trauma, its stressful effects, and the coping strategies of Saudi schoolchildren. The authors hypothesized that children exposed to war-related trauma will show higher levels of PTSD, and that those with higher levels of PTSD symptoms use more maladaptive coping strategies. The study describes the correlation between traumatic events and posttraumatic stress disorder (PTSD) as well as coping strategies. Five hundred twenty-seven intermediate and high school students, 12 to 18 years old, living in the conflict zone in southern Saudi Arabia completed three standardized self-reported scales: the War Zone Traumatic Events Checklist, the Child PTSD Symptom Scale, and the Children's Coping Strategies Checklist. Each participating student was randomly chosen. Analysis was based on two groups: the high-PTSD symptoms group (182 children) and the low-PTSD symptoms group (345 children). The study was conducted between September 2020 and April 2022 while the war was ongoing as part of an ongoing larger study. Children exposed to war-related traumatic events exhibited greater prevalence rates for PTSD. The children reported high levels of PTSD symptoms and applied a variety of coping strategies to manage related stress. Participants rarely reported that psychological or educational interventions had been used to manage the war-related traumatic experiences and PTSD or to improve related coping styles. The results are discussed in the context of mental health services needed for children in the conflict zone. To bridge the gap between health care services and the needs of children with PTSD, and for better understanding and interventions, health professionals are invited to develop a biopsychosocial model that identifies the risks of PTSD related to exposure to war-related traumatic events in school-aged children and, hence, provide a multidisciplinary intervention program that educates, encourages, and supports teachers and parents in following medical recommendations and goals.

COVID-19 prevention behaviors and dietary habits among undergraduate students: A health belief model approach

Physical and social disruptions resulted from the COVID-19 pandemic, affecting young adults in higher education. The purpose of this survey research is to unveil COVID-19 related beliefs using the Health Belief Model, and COVID-19 prevention behaviors, including self-reported fruit and vegetable consumption among university students. A cross-sectional survey was administered to 304 male and female undergraduate students from diverse ethnic backgrounds and majors at a New Jersey state university using convenience sampling. Variables measured included frequency of COVID-19 prevention behaviors (e.g.: wearing indoor mask, handwashing), and consumption of fruit and vegetables (dark green and orange vegetables) over the previous week. Health Belief Model constructs were assessed namely perceived susceptibility to COVID-19, severity, benefits, barriers, and self-efficacy. Statistical distributions were computed for the entire sample and t-tests were investigated for subgroups of age and sex. The sample mean age was 21.7 (SD = 4.7) years with 222 females (73%) and 82 males (27%), and 46% identified as White, non-Hispanics. Participants consumed a mean of 0.95 cups of fruit, 0.81 cups of green vegetables, and 0.46 cups of orange vegetables. Female students practiced more COVID-19 prevention behaviors with a mean difference of 0.26 (p<0.001), perceived greater severity from the virus (Δ = 0.37, p = 0.002) and had stronger perceptions of benefits (Δ = 0.18, p = 0.041), barriers (Δ = 0.21, p = 0.046), and self-efficacy (Δ = 0.20, p = 0.020) than their male counterparts. Older students (aged 23 and above) adopted more COVID-19 prevention behaviors (Δ = -0.35, p = 0.001) and perceived less barriers (Δ = 0.24, p = 0.047) than their younger peers. Nutrition educators and health professionals need to emphasize the importance of adopting preventive health behaviors among university students as strategies to mitigate the severity of COVID-19. Addressing barriers younger male and female students may elevate their motivation and self-efficacy to enact health behaviors.

The formation pattern, causes, and governance of network public opinion on university emergencies

Background

University emergencies, garnering significant public attention and shaping network opinions, pose a crucial challenge to universities' management and societal stability. Hence, network public opinion on university emergencies is a vital issue. Nevertheless, the underlying mechanism has not been fully explored and cannot be efficiently controlled. This study aimed to explore the formation pattern of network public opinion on university emergencies, analyze its causes, and provide scientific governance strategies for coping with this issue.

Methods

Based on a sample set of 204 cases from the Zhiwei Data Sharing Platform, this study classifies network public opinion on university emergencies into six types and visually analyzes their characteristics: time distribution, subject, duration, and emotion. By integrating the theory of the network public opinion field, this study develops a network public opinion field model of university emergencies to reveal its formation pattern. Furthermore, it analyzes the causes of network public opinion on university emergencies from the perspective of the public opinion lifecycle and proposes corresponding governance strategies.

Results

The sample consisted of 304 cases of real-life public opinion, and the visualization results show that public opinion on mental health and teacher-student safety constitutes the predominant types, accounting for 83.3%. High-occurrence subjects are public universities (88.24%) and students (48%). The most frequent months are July and December. 90.20% of the public opinions have a lifespan of less than 19 days, with an impact index ranging from 40 to 80. The public's emotional response to different types of public opinion varies, with negative emotions dominating.

Conclusion

This study provides novel insights for understanding their formation and dissemination. It also provides practical implications for relevant departments to govern network public opinion on university emergencies.

Impact of campus closure during COVID-19 on lifestyle, educational performance, and anxiety levels of college students in China

BACKGROUND

Higher education students exhibit heightened sensitivity to environmental changes as they navigate the critical transition from adolescence to adulthood. The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to universities worldwide, exemplifying a crisis that profoundly affects the learning outcomes and psychological status of college students. Although it is known that campus lockdown has triggered dramatic changes in lifestyles, learning outcomes, and psychological statuses, in-depth knowledge of the causal relationships among these changes remains largely unclear.

METHODS

Here, we conducted a cross-sectional survey designed to assess the impact of campus closure during COVID-19 on lifestyle, educational performance, and anxiety levels among college students. We surveyed over 3,500 junior college, undergraduate and graduate participants from 94 colleges/universities across 30 provinces, municipalities, and autonomous regions in China.We employed structural equation modeling (SEM) to explore the relationships between changes in lifestyle, educational performance, and levels of anxiety associated with campus open or closure regulations during the COVID-19 pandemic.

RESULTS

Our results discovered that sleep duration, physical activity involvement, and social connections were crucial for sustaining students' learning outcomes and mental health. The shift to online learning and campus lockdown exacerbated stressors, contributing to heightened anxiety (β = 0.066), disrupted sleep patterns, and enhanced physical activity (β = 0.070) and reduced learning effect (β = -0.059). Sleep patterns were disrupted by the campus lockdown, an effect mediated by the degradation of relationships among classmates. Nonetheless, the best-fitting SEM uncovered the intricate relationships among lifestyle changes, learning outcomes, and psychological status in response to sudden environmental changes (Fisher's C = 80.949, P = 0.328). These results highlight the critical role of adaptable, supportive campus policies tailored to meet the diverse needs and interests of students during and beyond crises (Fisher's C = 59.568, P = 0.809).

CONCLUSIONS

Our study advocates for a holistic approach that addresses the multifaceted aspects of student life to cultivate a resilient academic community. This approach contributes to a deeper understanding of the effects of sudden environmental changes on students' psychological well-being and academic performance in the post-pandemic era.

Graduate public health student learning experiences, social connectedness, and mental health during COVID-19: pedagogical implications for public health academic departments

Introduction

The COVID-19 pandemic impacted college student learning both globally and nationally. Current literature points to decreases in social connectedness, adverse mental health outcomes, and decreased overall learning outcomes; however, there are limited findings from higher education institutions within the Bay Area, California. There are also limited studies that examine the COVID-19 impact among public health graduate students, especially to understand how the pandemic renewed their interest in the field. The purpose of this study was to investigate the effects of COVID-19 on graduate student learning experiences, social connectedness and mental health within the Master of Public Health program at San José State University in San Jose, California.

Methods

We employed a convergent mixed-methods design using a survey that quantitatively assessed student learning experiences through a retrospective pre-and post-design, and a semi-structured interview guide that qualitatively assessed student learning experiences and its relationship with mental health and social connectedness using a phenomenological design. Data were collected between September 2022 and June 2023 and analysis was performed using descriptive statistics and thematic analysis.

Results

A total of 22 students completed the survey and four participated in follow-up semi-structured interviews. Of the 22, 12(54%) were among the 18-29-year age group, 9(41%) identified as Asian, 21(95%) identified as female, and 9(41%) identified as a first-generation college student. When comparing survey responses, the median change in learning experiences pre and during-pandemic were statistically significant across several areas such as student ability to stay organized (p < 0.0001), participate actively in class (p < 0.001), retain course material (p < 0.0001), collaborate with peers (p < 0.0001), and maintain a sense of connection with their cohort (p = 0.0001) and broader campus community (p < 0.0001). Semi-structured interviews further revealed the following six themes: (1) Consistent faculty support; (2) Sense of community; (3) Reduced social connectedness; (4) Impact on mental health; (5) Deeper public health understanding; and (6) Facilitators and barriers.

Conclusion

Educational practitioners are encouraged to offer hybrid academic programs and establish resource infrastructures that provide students with social and mental wellness support when transitioning to different learning modalities.

Psychological wellbeing of Italian students and clinical assessment tools at university counseling services during the COVID-19 pandemic: a systematic review

Introduction

The COVID-19 pandemic brought about unprecedented problems for contemporary society. Among the numerous challenges faced following the spread of the virus, the need to provide assessment tools and remote psychological assistance certainly deserves particular attention. Indeed, this profound paradigm shift in psychological assessment and care occurred during a period of fragility for people already suffering from the restrictions imposed to stem the spread of the virus. One population particularly affected by the pandemic was students, including university students. The latter faced the pandemic in a particularly critical formative period.

Methods

For these reasons, our systematic review has two main objectives: (i) identify the assessment tools and psychological dimensions most used/investigated during the pandemic in Italian university students; (ii) systematize and deepen our knowledge about the impact of the pandemic on the psychological wellbeing of Italian university students. Our search used PRISMA 2020 guidelines on Web of Science, Pubmed, Scopus, and EBSCOHost.

Results

The results indicated that the psychological dimensions most investigated in university students during the pandemic were anxiety and depression. At the same time, the most used assessment instruments were the State-Trait Anxiety Inventory (STAI-Y) and the Beck Depression Inventory-II (BDI-II). Furthermore, it is clear from the results that the pandemic has harmed the psychological wellbeing of university students. Finally, we dedicated a section to discuss the interventions implemented by university counseling services during the pandemic.

Discussion

This review could improve the work of university counseling services in this post-pandemic period and contribute to developing specific screening and assessment programs for future emergencies.

Well-being among university students in the post-COVID-19 era: a cross-country survey

University students have to handle crucial challenges for their future lives, such as succeeding in academic studies and finding attachment figures. These processes could potentially involve their well-being and mental health, with possible sociocultural differences based on the country of study. In order to explore such potential differences, a cross-sectional, multi-center survey was performed involving students from the University of Torino (Italy), Sevilla (Spain), and Lusòfona (Portugal). The survey, conducted from May to November 2023, investigated students' demographic and educational details, socioeconomic status, social support, mental health, academic environment, perceived COVID-19 pandemic impact, and future plans. Demographic profiles showed a predominance of female participants and straight sexual orientation, followed by bisexuality. Italian students showed the lowest levels of mental well-being and the highest rates of mental problems (anxiety and depression) and suicidal risk across the three countries despite the relatively similar profiles of social support. The prevalence of the students' confidence in their professional future is higher in Spain than in Italy and Portugal. This study provides a comprehensive examination of university students' mental health and well-being in three Southern European countries, addressing the major mental health challenges among university students and offering valuable insights for public health purposes.

Student Stress, Coping, and APPE Readiness at Two Public Institutions before and during the Pandemic

The coronavirus disease 2019 (COVID-19) pandemic significantly impacted pharmacy students' education and well-being. The primary aim of this study was to evaluate the effects of the pandemic on students' perceived stress by comparing third- and fourth-year students from the pre-pandemic Class of 2019 with mid-pandemic Class of 2021 at two public institutions. Secondary aims were to evaluate the pandemic effects on students' academic and professional development skills and practice readiness. The Perceived Stress Scale (PSS) and the Brief Coping Orientation to Problems Experienced (COPE) scale were used to measure student well-being. Students' self-rated problem-solving, time management, and study skills were used to measure their academic and professional development; practice readiness was measured using students' self-rated confidence levels. PSS scores were significantly higher in mid-pandemic than pre-pandemic students, and the Brief COPE avoidant coping subscale differed between pre-pandemic and mid-pandemic students. No differences were found in any academic and professional development skills between the pre- and mid-pandemic students, and there were significant improvements in student confidence levels for practice readiness among the mid-pandemic students. In conclusion, the pandemic appeared to affect students' stress and avoidant coping mechanism but had variable effects on academic and professional development and practice readiness.

Bi-Directional and Time-Lagged Associations between Engagement and Mental Health Symptoms in a Group Mindfulness-Based Mental Health Intervention

There is a high need for accessible avenues for improving mental health among emerging adults, particularly on college campuses. Mindfulness-based intervention (MBI) is a promising avenue for reducing mental health symptoms, but initial discomforts associated with MBI may cause symptoms to fluctuate before decreasing, which presents a barrier to engagement with mindfulness on a daily basis. Consistent mindfulness practice is key for forming habits related to MBI, and engagement with mindfulness at home, including between intervention sessions, is an important predictor of mental health outcomes. Research suggests that mental health symptoms may serve as barriers to their own treatment. Thus, it is important to understand how mental health symptom levels impact adherence to treatment protocols. To improve understanding of symptom-specific barriers to treatment and engagement with mindfulness, the present study collected daily diary surveys about engagement with mindfulness and mental health symptoms from a sample of 62 adults recruited to participate in a six-week mindfulness intervention. We explored mental health symptoms as a predictor of engagement with MBI at the mean level and whether within-person variability in symptoms predicted same-day or time-lagged changes in engagement via mixed-effects associations. Using heterogeneous location scale models, we further explored whether erraticism in either mental health symptoms or engagement with mindfulness predicted the other and if outcomes of the mindfulness intervention were homogeneous among subjects. Results showed that bi-directional and time-lagged associations exist between symptoms and engagement, indicating that there is a nuanced temporal and reciprocal relationship between engagement with mindfulness and mental health symptoms. Daily within-person elevations in engagement with mindfulness were associated with concurrent improvements in mental health but prospective increases in mental health symptoms. We also found that higher engagement (over personal averages) was not consistently associated with improvements in mental health across the sample but was instead associated with greater heterogeneity in outcomes. We also found that increases in mental health symptoms (over personal averages), as well as higher average levels of mental health symptoms, were both associated with lower levels of engagement in the mindfulness treatment protocol.

Impact of the COVID-19 pandemic on suicide-related risk among college students: A cross-sectional analysis

This study aimed to investigate the factors contributing to suicide-related risks among college students during a stressful life event, specifically the COVID-19 pandemic. Employing a Classification and Regression Tree (CART) model, data from 808 college students were analyzed, revealing key interactions and predictive insights into suicide-related risk. Results indicated that preexisting depression emerged as the most significant risk factor, followed by anxiety, discrimination, stress, and younger age. These findings emphasize the importance of preventive measures targeting depression and anxiety to enhance college students' mental health and well-being. The study's implications extend to informing future research, practical interventions, and policy-making efforts addressing suicide-related risk among college students.

Online learning predictors of mental health in third-level students during the COVID-19 pandemic in Ireland

Objective COVID-19 forced third-level students to transition to online learning (OL). Many students encountered issues with OL, such as accessibility. However, the relationship between OL issues and mental health during this time remains poorly understood. Participants: Third-level students in Ireland (N = 268) completed an online questionnaire examining experiences with OL and mental health during COVID-19. Methods: OL social, lecturer, accessibility, individual skills, and environment issues, were entered into logistic regression analyses to examine whether these variables predicted mental health outcomes and/or preference to keep OL. Results: Students reporting more individual skills issues were more likely to attain a probable diagnosis of posttraumatic stress disorder, complex posttraumatic stress disorder, and depression (p < 0.0083); students who reported more environment issues were less likely to report preference to keep OL (p < 0.0005). Conclusions: Given individual skills issues associated with worse mental health, future research should examine improving student perceptions of their own OL skills.

Proactive vitality management, goal attainment, and psychological well-being among college students: A weekly diary study

Student well-being is under renewed scrutiny due to escalating academic stress and mental health concerns among young adults. However, in addition to the measures taken by lecturers, universities, and local governments (top-down approaches), we still know little about how students themselves can take the proactive strategy to manage their well-being (bottom-up approaches). The current study addressed this gap by proposing and examining the beneficial role of proactive vitality management (PVM)-a proactive action aimed at managing physical and mental energy based on personal unique needs and conditions-on student psychological well-being. We collected data from 97 college students (36% male, age mean = 21) over four consecutive weeks (308 data observations) and tested a multilevel moderated mediation model. Results showed that weekly PVM was positively related to student weekly goal attainment, which, in turn, enhanced the current week's well-being and the next week's well-being as well. Further, this positive indirect (carryover) effect of PVM through goal attainment on well-being was stronger for those who had a high learning orientation. Our results indicated that PVM can be an effective self-customized strategy to manage college students' weekly well-being. Theoretical and practical implications were discussed.

Mental health and health behaviors among college student mentors in a randomized controlled trial interrupted by COVID-19

Objective: The benefits of mindfulness-training and mentoring for college students have yet to be investigated. We aimed to provide an exploratory and descriptive account of their potential benefits during the COVID-19 pandemic. Participants: In February 2020, 49 undergraduates (M = 20.51 years-old; 94% female) participated in a randomized trial of 12-week mentoring + mindfulness or mentoring-as-usual. After five weekly mentoring-sessions, programs were interrupted by COVID-19; mentoring continued online. Methods: Undergraduates completed questionnaires about mental health, behaviors, and regulatory processes in February and July 2020, with additional COVID-19-related questions at follow-up. Results: Participants reported moderate COVID-19-related perceived stress, but mental health, health behaviors, and regulatory processes did not diminish over time, with no condition differences. Undergraduates described using contemplative practices and social support to cope with COVID-19-stress. Conclusions: Undergraduates showed stable mental health/health behaviors despite moderate COVID-19-related-stress. Future research on mentoring with a mindfulness component among a larger and more heterogeneous sample will be necessary.

Mental health and academic performance of college students: Knowledge in the field of mental health, self-control, and learning in college

The aim of this research is to analyze the impact of mental health on the academic performance of junior and senior students studying in a university setting during the 2022-2023 academic year, in the post-COVID period. The study was conducted in Beijing, China, with the participation of 600 students, including 300 first-year students and 300 fifth-year students. DASS (Depression, Anxiety, and Stress Scale) and PHQ-9 (Patient Health Questionnaire-9) questionnaires were employed to measure mental health. The DASS assesses symptoms of depression, anxiety, and stress, while the PHQ-9 specifically evaluates depression severity. Academic performance was evaluated using a 12-point scale, which incorporated various criteria such as exam scores, coursework performance, and participation in extracurricular activities. The research was conducted across five faculties of the university from 2022 to 2023. In the study, fifth-year students demonstrated a higher level of mental health compared to first-year students, with an average DASS score of 27.1 and 24.2, respectively. Interestingly, despite this, first-year students achieved higher academic performance indicators, with an average score of 8.2 compared to 9.8 in fifth-year students. Correlation analysis revealed significant associations between stress, depression, and anxiety levels with academic performance (stress: r = -0.25, p < 0.001; depression: r = -0.20, p = 0.003; anxiety: r = -0.18, p = 0.008). These findings highlight the critical importance of addressing students' mental well-being, particularly in later academic years. Recommendations include implementing support programs and developing online resources for students.

Impact of COVID-19 stress on food insecurity and fruit and vegetable consumption among college students

Objective: This cross-sectional study utilized structural equation modeling to examine effects of COVID-19 stress on food insecurity and fruit and vegetable consumption mediated through personal agency and behavioral intention. Participants: Students (n = 749) enrolled at one federally designated Hispanic-serving public university during the fall 2020 semester. Methods: A 34-item survey was developed and administered. Results: COVID-19 stress had a statistically significant impact on food insecurity (B = .341; p < .001) and an inverse impact on personal agency to consume fruit and vegetables (B = -.283; p < .001). Personal agency (B = .389; p < .001) and behavioral intention to consume fruit and vegetables were directly associated while food insecurity inversely impacted behavioral intention (B = -.076; p = .034). Conclusions: Pandemic-related stress impacts nutrition behaviors among the student population already at risk of poor fruit and vegetable intake. During periods of high pandemic-related stress, college students need adequate access to fruits and vegetables and health promotion programs emphasizing stress management and healthy dietary behaviors.

Emotional Eating in College Students: Associations with Coping and Healthy Eating Motivators and Barriers

BACKGROUND

Emotional eating, or eating in response to stress and other negative affective states, bears negative consequences including excessive weight gain and heightened risk of binge eating disorder. Responding to stress with emotional eating is not universal, and it is important to elucidate under what circumstances and by what mechanisms stress is associated with emotional eating. This is particularly important to understand among college students, who are at risk of experiencing heightened stress and negative changes to dietary habits.

METHOD

The present study investigated the relationships among perceived stress, emotional eating, coping, and barriers to and motivators of healthy eating both concurrently and 1 year later in a sample of young adult college students (n = 232).

RESULTS

At baseline, emotional eating was significantly associated with perceived stress (r = 0.36, p < .001), barriers to (r = 0.31, p < .001) and motivators of (r =  - 0.14, p < .05) healthy eating, and avoidance coping (r = 0.37, p < .001), but not approach coping. Furthermore, avoidance coping mediated (indirect effect b = 0.36, 95% CI = 0.13, 0.61) and moderated (b =  - 0.07, p = 0.04) the relationship between perceived stress and emotional eating. Contrary to study hypotheses, baseline stress levels were not associated with emotional eating 1 year later.

CONCLUSION

College students who utilize avoidance coping strategies may be particularly susceptible to the effects of stress on emotional eating. Healthy eating interventions targeting college students might address stress coping strategies in addition to reduction of barriers to healthy eating.

Relevance of spirituality and perceived social support to mental health of people with pre-existing mental health disorders during the COVID-19 pandemic: a longitudinal investigation

BACKGROUND

The COVID-19 pandemic and related measures have negatively impacted mental health worldwide. The main objective of the present longitudinal study was to investigate mental health in people living in Tyrol (Austria) and South Tyrol (Italy) during the COVID-19 pandemic and to report the prevalence of psychological distress among individuals with versus those without pre-existing mental health disorders (MHD) in the long-term (summer 2020-winter 2022). Here, we specifically focus on the relevance of spirituality and perceived social support in this regard.

METHODS

161 individuals who had been diagnosed with MHD and 446 reference subjects participated in this online survey. Electronic data capture was conducted using the Computer-based Health Evaluation System and included both sociodemographic and clinical aspects as well as standardized questionnaires on psychological distress, spirituality, and the perception of social support.

RESULTS

The prevalence of psychological distress was significantly higher in individuals with MHD (36.6% vs. 12.3%) and remained unchanged among both groups over time. At baseline, the perception of social support was significantly higher in healthy control subjects, whereas the two groups were comparable in regards of the subjective relevance of faith. Reference subjects indicated significantly higher spiritual well-being in terms of the sense of meaning in life and peacefulness, which mediated in large part the between-group difference of psychological distress at follow-up. Notably, both faith and the perception of social support did not prove to be relevant in this context.

CONCLUSIONS

These findings point to a consistently high prevalence of psychological distress among people suffering from MHD and underscore the prominent role of meaning in life and peacefulness as a protective factor in times of crisis. Therapeutic strategies that specifically target spirituality may have a beneficial impact on mental health.

Body weight in relation to hours of sleep, and physical activity in Latin American university students during the Covid-19 pandemic

Introduction: Short sleep, physical inactivity, and being locked up are risk factors for weight gain. Objective: We evaluated weight gain according to sex, age, hours of sleep and physical activity in university students from 10 Latin American countries during the COVID-19 pandemic. Methods: Cross-sectional and multicenter study (n = 4880). Results: The average age was 22.5 ± 4.4 years. 60.2% were currently locked up. 73.6% were women, 48.2% increased their body weight, 66% reported insufficient sleep hours, and 65.9% were inactive. Women gained more weight than men (73.2%) and younger students gained more weight (85.1%). Those who had insufficient sleep hours gained most weight (67.6%). Inactive participants gained most weight (74.7%). Students who have insufficient sleep are 21% more likely to have changes in body weight compared to students who have optimal sleep. Conclusion: The increase in body weight and its risk factors during confinement should be considered as emerging from public health.

Perceived stress and coping strategies among nursing students towards rejoining college after covid-19 pandemic

The COVID-19 pandemic has had a significant impact on nursingeducation, with many programs abruptly discontinuing clinical practice. This has raised concerns among nursing students about their clinicalskill development. Because of this, the researcher was motivated to learn how nursing students perceive stress and develop coping mechanisms for returning to nursing colleges following the COVID-19 pandemic. This study aimed to assess perceived stress and coping strategies among nursing students toward rejoining college after COVID -19 pandemic.Ananalyticalcross-sectionalstudywas conducted using proportionatestratified simple random sampling technique among 317 nursing students of bachelor level at all nursing colleges affiliated to Purbanchal University in Kathmandu Valley. Data was collected usingaself-administeredquestionnaire that included the Perceived Stress Scale (PSS) and the Brief COPEScale.The majority of respondents (71.3%) reported moderate stress levels, with 28.7%reportinghighstresslevels.Half of the respondents (51.7%) had low coping levels, while the other half (48.3%) had high coping levels. There was a significant association between the level of coping and mother's occupation (p = 0.003). The Pearson correlation between perceived stress and coping strategies was moderately positive (r = 0.256, p = 0.001).Nursing college administration and instructors can play a role in reducing student stress and promoting coping strategies by maintaining a safecollege environment for students rejoining college after the COVID-19 pandemic.

Predictors of grit among medical students: a study at a Malaysian Public University

BACKGROUND

Previous literature has demonstrated associations between grit and positive educational and psychological outcomes, such as higher academic grades, lower attrition rates in medical training, and protection from burnout. However, the predictors of grit have yet to be studied, particularly among medical students in Malaysia. This study aimed to determine the level of grit and its predictors among Malaysian medical students.

METHODS

A cross-sectional study was conducted among 123 medical students from a public university in Malaysia. Data on sociodemographic and educational characteristics were collected. The student's personality traits were determined using the Big Five Inventory (BFI), while grit was assessed using the validated 7-item Short Grit Scale (Grit-S). Grit was expressed as a mean score, ranging from 1 (not at all gritty) to 5 (extremely gritty). Multiple linear regression was used to determine the association between the predictors (personality, sociodemographic and educational characteristics) and grit among these students.

RESULTS

The mean grit score was 3.43 (SD 0.57). Based on the multiple linear regression analysis, the grit score was significantly predicted by three personality traits which were extraversion, b = 0.2 (95% CI: 0.07-0.32), agreeableness, b = 0.28 (95% CI: 0.12-0.44) and conscientiousness, b = 0.6 (95% CI: 0.42-0.77). A 1-point increase in the mean extraversion, agreeableness, and conscientiousness scores would independently increase these students' mean grit scores by 0.2, 0.28, and 0.6, respectively. The sociodemographic and educational characteristics did not significantly predict grit among Malaysian medical students.

CONCLUSIONS

The mean grit score among Malaysian medical students is comparable to other medical students in Asia. Extraversion, agreeableness, and conscientiousness personality traits were associated with higher grit. As grit is a dynamic trait, appropriate interventions should be implemented to foster and increase it among these students.

The Relationship Between Negative Urgency and Anxiety and Worry in American College Students

The primary objective was to assess the degree to which intolerance of uncertainty accounts for the association between negative urgency and anxiety and worry. The sample included 389 American college students from a state college in the Northeastern United States. Hayes' PROCESS v4.1 (2022) macro was used to investigate the mediating effects of intolerance of uncertainty on the relationship between negative urgency and worry and anxiety. A direct effect of negative urgency on worry was found and a mediating effect of intolerance of uncertainty was observed. A direct effect of negative urgency on state anxiety was found, and a mediating effect of intolerance of uncertainty was observed. The study advances support for the mediatory role of intolerance of uncertainty between negative urgency and anxiety and worry in American college students.

Trends and factors influencing the mental health of college students in the post-pandemic: four consecutive cross-sectional surveys

Background

The long-term impact of COVID-19 on the mental health and well-being of college students, specifically trends over time after full removal of COVID-19 restrictions, has not been well-studied.

Methods

Four consecutive cross-sectional surveys were conducted in December 2022 (N = 689), March 2023 (N = 456), June 2023 (N = 300), and November 2023 (N = 601) at a university in Sichuan Province, China.

Results

The proportion of students with COVID-19 panic decreased from 95.1 to 77.3% (p < 0.001). The prevalence of moderate anxiety and above decreased from 18 to 13.6% (p < 0.001), and the prevalence of moderate and above depression decreased from 33.1 to 28.1% (p < 0.001), while the prevalence of post-traumatic stress disorder (PTSD) increased from 21.5 to 29.6% (p < 0.005). Further, the proportion of suicidal thoughts increased from 7.7 to 14.8% (p < 0.001). Suicidal thoughts and self-injuries were significantly associated with COVID-19 panic, depression, anxiety, and PTSD. Students who reported being in close contact with COVID-19 patients in the past were more likely to develop PTSD. Further, COVID-19-induced panic was a risk factor for self-injury.

Conclusion

One year after the COVID-19 pandemic, the overall mental health of college students was not optimal. Hence, we can conclude that the long-term impacts of COVID-19 on the mental health of college students may have already occurred. To mitigate this impact and prepare for the next major public health event, strengthening college students' mental health curricula and promoting healthy behaviors among college students should be a priority for universities and education authorities.

Exploring Symptom Overlaps: Post-COVID-19 Neurological Syndrome and Post-Concussion Syndrome in Athletes

The COVID-19 pandemic has introduced new challenges in managing neurological conditions, particularly among athletes. This paper explores the intersection of post-COVID-19 neurological syndrome (PCNS/PASC) and post-concussion syndrome (PCS), focusing on their implications in sports medicine. Our analysis covers the symptomatology, pathophysiology, and management strategies for PCNS/PASC and PPCS, with special attention paid to the unique challenges faced by athletes recovering from these conditions, including the risk of symptom exacerbation and prolonged recovery. Key findings reveal that both PCNS/PASC and PPCS present with overlapping symptoms such as cognitive difficulties, exercise intolerance, and mental health issues, but differ in specific manifestations like anosmia and ageusia, unique to COVID-19. Pathophysiological analysis reveals similarities in blood-brain barrier disruption (BBB) but differences in the extent of immune activation. Management strategies emphasize a gradual increase in physical activity, close symptom monitoring, and psychological support, with a tailored approach for athletes. Specific interventions include progressive aerobic exercises, resistance training, and cognitive rehabilitation. Furthermore, our study highlights the importance of integrating neurology, psychiatry, physical therapy, and sports medicine to develop comprehensive care strategies. Our findings underscore the dual challenge of COVID-19 and concussion in athletes, necessitating a nuanced, interdisciplinary approach to effective management. Future research should focus on the long-term neurological effects of both conditions and optimizing treatment protocols to improve patient outcomes. This comprehensive understanding is crucial for advancing the management of athletes affected by these overlapping conditions and ensuring their safe return to sports.

Lifestyles and Academic Stress in University Students of Health Sciences: A Mixed-Methodology Study

The global health emergency generated by the COVID-19 pandemic (caused by the SARS-CoV-2 virus) led to the implementation of extraordinary measures such as confinement and isolation in many countries to mitigate the spread of the virus. (1) This study analyzes the lifestyles and academic and perceived stresses of university students of health sciences during the period of online learning due to the COVID-19 pandemic. The relationship between lifestyles and academic stress was examined. (2) A parallel mixed-method convergent study was conducted, with a correlational non-experimental design. Quantitative and qualitative data were collected and analyzed in parallel, with parametric and nonparametric testing for quantitative data and Miles and Huberman's approach to qualitative analysis. The qualitative findings complemented the quantitative results. The number of students who participated in this study was 2734, from six programs in health, nursing, medicine, clinical laboratory, physiotherapy, dentistry, and clinical psychology at the University of Chimborazo, Ecuador. (3) Overall, the health science students had "Unhealthy or health-compromising lifestyles", medical students being the ones who have healthier lifestyles. However, more than 80% experienced and perceived stress during the period of online learning and social isolation due to the pandemic, women being the ones who experienced it at a higher level. (4) The online learning modality during the COVID-19 pandemic modified lifestyles and generated stress in health science students, due to changes in daily routines, sedentary lifestyle, and stress, as a result of social isolation. Therefore, the students prefer face-to-face teaching, perceived as enabling more enriching interactions with their teachers and peers and the opportunity to develop essential practical skills in their health practice.