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

Covid-19 psychological pressures, depression and FOMO: the mediating role of online social support and emotional regulation

BACKGROUND

The spread of the coronavirus has led to significant anxiety among university students, resulting in various mental health problems that could potentially impact their academic performance.

METHOD

To examine the mediating role of emotional regulation and online social support in the relationships between COVID-19 psychological pressures, depression, and the fear of missing out (FoMO) among young adult university students, a cross-sectional research design was employed using an online survey. The sample consisted of 521 full-time university students from China, currently enrolled in undergraduate and postgraduate programs.

RESULTS

Findings revealed that more than half (55.09%, n=287) of the university students experienced COVID-19 psychological pressures. These pressures directly contributed to increased levels of depression (β = 0.339, p < .001) and fear of missing out (β = 0.236, p < .001). Moreover, online social support and emotional regulation exhibited partial mediating effects on the association between COVID-19 psychological pressures, depression, and the fear of missing out. The results indicated that COVID-19 psychological pressures were linked to higher levels of depressive symptoms and a greater fear of missing out among university students.

CONCLUSIONS

However, the provision of timely and adequate online social support, as well as the implementation of emotional regulation strategies, mitigated the negative effects of the pandemic on students' social and emotional well-being. Consequently, this led to reduced levels of depression and fear of missing out.

Capturing the College Experience: A Four-Year Mobile Sensing Study of Mental Health, Resilience and Behavior of College Students during the Pandemic

Understanding the dynamics of mental health among undergraduate students across the college years is of critical importance, particularly during a global pandemic. In our study, we track two cohorts of first-year students at Dartmouth College for four years, both on and off campus, creating the longest longitudinal mobile sensing study to date. Using passive sensor data, surveys, and interviews, we capture changing behaviors before, during, and after the COVID-19 pandemic subsides. Our findings reveal the pandemic's impact on students' mental health, gender based behavioral differences, impact of changing living conditions and evidence of persistent behavioral patterns as the pandemic subsides. We observe that while some behaviors return to normal, others remain elevated. Tracking over 200 undergraduate students from high school to graduation, our study provides invaluable insights into changing behaviors, resilience and mental health in college life. Conducting a long-term study with frequent phone OS updates poses significant challenges for mobile sensing apps, data completeness and compliance. Our results offer new insights for Human-Computer Interaction researchers, educators and administrators regarding college life pressures. We also detail the public release of the de-identified College Experience Study dataset used in this paper and discuss a number of open research questions that could be studied using the public dataset.

From Campus to Crisis: Psychological Effect of the COVID-19 Pandemic on Indian Management Students

BACKGROUND

The COVID-19 pandemic has adversely affected students pursuing higher education, but limited studies highlight student's psychological experiences, especially from Western India.

OBJECTIVE

The present study aimed to understand psychological experiences, coping behaviors, and the perceived role of tele-counseling services among final-year students of Masters of Business Administration from leading business schools (B-schools) in Western India.

DESIGN

A qualitative research design was adopted for the study. A semi-structured interview guide was utilized to conduct in-depth interviews with 35 students. Students were reached via personal networks and social media, and data was gathered after the second wave of the COVID-19 pandemic. A thematic analysis technique was employed to analyze the data.

RESULTS

The findings showed that management students had upsetting psychological experiences. Key stressors that emerged in the study were job concerns, lifestyle changes, concerns about their own and parents' health and safety, uncertainty about the future, and social isolation. They expressed the need for mental health help; however, they were reluctant to utilize tele-counseling services. The authors present an integrated psychological well-being model for promoting positive mental health among students in higher education institutions.

CONCLUSION

The study explains the psychological toll on management students. Enhancing mental health literacy through awareness sessions and other innovative means would be critical to addressing myths around mental health and mental healthcare-seeking behavior in higher education institutions. An integrated approach to promoting positive mental health and well-being is needed.

A 2-year mental health follow-up study subsequent to COVID-19

The COVID-19 pandemic has profoundly impacted the mental health and education of college students. This study examined the interrelationships among loneliness, resilience, and COVID-19 fear among college students in Northern Michigan, a region of the United States severely affected by the pandemic. Data were collected from two student cohorts (n = 258), with half surveyed in early 2022 and the other half in mid-2022, two years after pandemic's onset. The Omicron wave peaked in Michigan in January 2022, but by June 2022, cases, hospitalizations, and deaths had significantly declined. Students completed measures of loneliness, resilience, learning difficulty, and psychological symptoms. Key findings are: 1) Participants' fear, loneliness, and academic difficulty decreased over time, reflecting fluctuations in acute situational and emotional states; 2) Unexpectedly, resilience declined from early to mid-2022, suggesting its diminishing protective role under prolonged, pandemic-induced stress; 3) Despite improvements, students continued reporting high academic difficulties. Loneliness, heightened fear, and dampened happiness together contributed to greater academic difficulties; 4) Pre-existing sex differences equalized two years after the pandemic's onset. While modest improvements were noted, enduring academic and mental health impacts signal a need for continued support.

Midwives' views about the effects of climate change on maternal and child health: A qualitative study

BACKGROUND

Midwives have important responsibilities to protect the health of mothers and children from the negative effects of climate change.

AIM

This research was conducted to determine how midwives perceived climate change, the effects of climate change on maternal and child health, and what midwives could do to combat these effects.

METHODS

The research was designed as a case study, one of the qualitative research designs. The research sample consisted of 11 midwives selected by snowball sampling, which is one of the non-random sampling methods.

FINDINGS

The data obtained were collected under five main themes. The themes were determined as "(I) the causes of climate change, (II) concerns about the consequences of climate change, (III) the effects of climate change on mother-child health, (IV) measures to mitigate the effects of climate change, and (V) midwives' role in protecting mother-child health against the effects of climate change."

CONCLUSION

Midwives are knowledgeable about climate change. They are aware of the effects of climate change on maternal and child health and they are doing some practices in this regard (breastfeeding, promoting the regulation of fertility and adequate/balanced nutrition, etc.). Midwives are aware of the importance of the midwifery profession in raising awareness of the individual and society, in addressing the effects of climate change on human health and in reducing the negative effects of climate change on health, and they want to take action at the national level (with the support of the midwifery organization and the state) for the sustainability of health.

Impact of the COVID-19 Pandemic on People Living With Rare Diseases and Their Families: Results of a National Survey

BACKGROUND

With more than 103 million cases and 1.1 million deaths, the COVID-19 pandemic has had devastating consequences for the health system and the well-being of the entire US population. The Rare Diseases Clinical Research Network funded by the National Institutes of Health was strategically positioned to study the impact of the pandemic on the large, vulnerable population of people living with rare diseases (RDs).

OBJECTIVE

This study was designed to describe the characteristics of COVID-19 in the RD population, determine whether patient subgroups experienced increased occurrence or severity of infection and whether the pandemic changed RD symptoms and treatment, and understand the broader impact on respondents and their families.

METHODS

US residents who had an RD and were <90 years old completed a web-based survey investigating self-reported COVID-19 infection, pandemic-related changes in RD symptoms and medications, access to care, and psychological impact on self and family. We estimated the incidence of self-reported COVID-19 and compared it with that in the US population; evaluated the frequency of COVID-19 symptoms according to self-reported infection; assessed infection duration, complications and need for hospitalization; assessed the influence of the COVID-19 pandemic on RD symptoms and treatment, and whether the pandemic influenced access to care, special food and nutrition, or demand for professional psychological assistance.

RESULTS

Between May 2, 2020, and December 15, 2020, in total, 3413 individuals completed the survey. Most were female (2212/3413, 64.81%), White (3038/3413, 89.01%), and aged ≥25 years (2646/3413, 77.53%). Overall, 80.6% (2751/3413) did not acquire COVID-19, 2.08% (71/3413) acquired it, and 16.58% (566/3413) did not know. Self-reported cases represented an annual incidence rate of 2.2% (95% CI 1.7%-2.8%). COVID-19 cases were more than twice the expected (71 vs 30.3; P<.001). COVID-19 was associated with specific symptoms (loss of taste: odds ratio [OR] 38.9, 95% CI 22.4-67.6, loss of smell: OR 30.6, 95% CI 17.7-53.1) and multiple symptoms (>9 symptoms vs none: OR 82.5, 95% CI 29-234 and 5-9: OR 44.8, 95% CI 18.7-107). Median symptom duration was 16 (IQR 9-30) days. Hospitalization (7/71, 10%) and ventilator support (4/71, 6%) were uncommon. Respondents who acquired COVID-19 reported increased occurrence and severity of RD symptoms and use or dosage of select medications; those who did not acquire COVID-19 reported decreased occurrence and severity of RD symptoms and use of medications; those who did not know had an intermediate pattern. The pandemic made it difficult to access care, receive treatment, get hospitalized, and caused mood changes for respondents and their families.

CONCLUSIONS

Self-reported COVID-19 was more frequent than expected and was associated with increased prevalence and severity of RD symptoms and greater use of medications. The pandemic negatively affected access to care and caused mood changes in the respondents and family members. Continued surveillance is necessary.

Mental health disorders among medical students during the COVID-19 pandemic in the area with no mandatory lockdown: a multicenter survey in Tanzania

The COVID-19 pandemic brought about a major public health concern worldwide. It forced many countries to enforce lockdowns, leading to the closure of higher learning institutions. The abrupt shift in the lifestyle of students had a profound impact on their mental health. This study aims to determine the prevalence and factors associated with mental health conditions among university students in Tanzania during the COVID-19 pandemic. A sample of 425 students from six medical universities and colleges in Tanzania completed an online survey and was included in the analysis. The questionnaire consisted of validated Depression, Anxiety and Stress Scale-21 Items (DASS-21) questions (Cronbach's alpha = 0.92) assessing the presence of mental health symptoms: depression, anxiety, and stress. Multivariable logistic regression models were fitted to explain the factors associated with mental health conditions. A P-value < 0.05 was considered statistically significant in all inferential analyses. The median age (interquartile range) of the participants was 24 (22-26). The prevalence of mental health conditions was 28.94%, 54.12%, and 15.06% for depression, anxiety, and stress, respectively, while the prevalence of having any mental health condition was 58.59%. In an adjusted regression model, being in the fourth and fifth years of study and living with a spouse were significantly associated with increased odds of depression: AOR = 5.99 (1.31-27.47), AOR = 5.52 (1.18-25.81), and AOR = 1.84 (1.08-3.15), respectively. Moreover, studying in private universities and living with a spouse were significantly associated with an increased likelihood of anxiety: AOR = 2.35 (1.72-2.76), and AOR = 2.32 (1.20-4.50), respectively. The likelihood of stress was only among participants studying in private universities; AOR = 2.90 (1.60-5.27). The study revealed alarmingly high rates of mental health conditions among medical students in Tanzania during the COVID-19 pandemic. The findings suggest the need for regular checkups for medical students regarding their mental health status. Additionally, it recommends that the government and other stakeholders establish mental health services within the universities for the effective prevention of the rising burden of mental health problems among universities in Tanzania and other countries with similar settings.

Impact of COVID-19 on the mental health of adolescents and youth in Nairobi, Kenya

Objective

To report on the mental health status of adolescents and youth in relation to the COVID-19 pandemic in Nairobi County, Kenya.

Methodology

This was a mixed-methods study with cross-sectional quantitative and qualitative components conducted in Nairobi County, Kenya from August to September 2020. The quantitative survey involved phone interviews of n = 1,217 adolescents and youth. Qualitative components included virtual focus group discussions (FGDs) with adolescents and youth (n = 64 unmarried youths aged 16-25 years, across 8 FGDs) and youth-serving stakeholders (n = 34, across 4 FGDs), key informant interviews (n = 12 higher-level stakeholders from Ministries of Health, Gender, and Education), and in-depth interviews with youth (n = 20) so as to examine the COVID-19 impact on mental health.

Results

Among the participants, 26.6% of young men and 30.0% of young women reported probable depressive symptoms, of whom 37.7% of young men and 38.9% of young women reported little interest or pleasure in doing various activities. Hopelessness and feeling down nearly every day was additionally reported by 10.7% of young women and 6.3% of young men. Further, about 8.8% of young men and 7.6% of young women reported they could not get the emotional help and support they may need from people in their life. Multivariable regression results showed an association between depressive symptoms and reduced working hours due to COVID-19 and increased intimate partner violence. Additionally, the results show that respondents with higher emotional help and support were less likely to report depressive symptoms. Qualitative results confirm the quantitative findings and exemplify the negative behavior arising from the impact of adherence to COVID-19 prevention measures.

Conclusion

Mental health issues were common among adolescents and youth and may have been augmented by isolation and economic hardships brought about by COVID-19 restrictions. There is a need for concerted efforts to support adolescents and young people to meet their mental health needs, while considering the unique variations by gender. There is need to urgently strengthen the mental health system in Kenya, including via integrating psychosocial support services in communities, schools, and healthcare services, to ensure adolescents and young persons are not left behind.

The relationship between anxiety and academic identity and the motivation to study nursing and midwifery in the covid-19 pandemic: A structural model

BACKGROUND

The coronavirus disease (COVID-19) pandemic had a great psychological effect on health service providers and students of related fields. The study aimed to investigate the relationship between COVID-19 anxiety and academic identity and the motivation to study nursing and midwifery during the COVID-19 pandemic.

MATERIALS AND METHODS

In a cross-sectional study 221 nursing and midwifery students at-University of Medical Sciences in 2020 using census sampling were studied. The questionnaires were GADQ-7, the student's academic identity standard questionnaire, the coronavirus anxiety scale, and academic motivation in nursing and midwifery. Pearson's correlation coefficient, regression coefficient, and path analysis were used in statistical software AMOS (version 21) and SPSS (version 22).

RESULTS

The results showed that motivation and anxiety with a significant overall effect of 0.43 and -0.36 were the main determining variables of academic identity respectively (P < 0.001). COVID-19 anxiety was recognized as responsible for 24% of the changes in motivation to study nursing (P < 0.001).

CONCLUSIONS

Academic identity and motivation to study nursing and midwifery have been affected by the COVID-19 pandemic. The need for psychological attention in this situation is required for nursing and midwifery students.

Effects of the COVID-19 Pandemic on University Students' Mental Health: A Literature Review

This review aims to focus on the effects of COVID-19 on university students' mental health and deepen our understanding of it. The conclusions are based on the review of 32 studies conducted during the pandemic. This review confirms that university students were at high risk for mental health disorders, heightened stress, and increased sleep comorbidities both pre-pandemic and during the pandemic. This literature review confirmed a few universal trends, i.e., increased stress, anxiety, and depression, during the pandemic. The rates of insomnia, obsessive-compulsive disorder, and suicidal ideation also went up. Overall, female students are at a disadvantage in the development of mental health issues. Male students coped better but may be at higher risk for lethality in suicidal ideation. Students with a history of mental health issues and other comorbidities prior to the pandemic had worse outcomes compared to healthy individuals. The study points to a strong positive correlation between fear and increased rates of stress, anxiety, and insomnia. There is also a positive correlation between declining mental health and online learning. A strong negative correlation was present between physical activity and depressive symptoms. These findings are universal across many countries and regions where the studies occurred.

Remote-delivered services during COVID-19: A mixed-methods survey of college counseling center clinicians

OBJECTIVE

The COVID-19 pandemic has drastically increased use of remote-delivered mental health services. This study identifies advantages and limitations of remote-delivered services on college campuses to inform mental health delivery post-pandemic. Methods: Clinicians (n = 30) were asked to evaluate COVID-19's impact on their work, environment, and wellness in an online survey. Qualitative data was coded using a thematic analysis approach, while quantitative data was analyzed using descriptive statistics. Results: Many clinicians reported benefits of remote services, including increased accessibility, greater convenience, no change in therapeutic alliance, and decreased stress for clinicians. Clinicians also experienced challenges such as social isolation, technological difficulties, and personal/family concerns. Clinicians envisioned a hybrid service combining online and in-person activities post-pandemic. Conclusions: Overall, remote-delivered mental health services on college campuses have potential in increasing treatment quality while highlighting a necessity for further research in hybrid mental health delivery.

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2022.2038178 .

Fear of COVID-19, anxiety, and social support among college students

OBJECTIVE

The present study prospectively examined the association between fear of COVID-19 and anxiety and whether social support moderated this association among college students.

PARTICIPANTS

1,539 students from 11 universities in the United States completed two online surveys, one prior to the COVID-19 pandemic and one during the pandemic.

METHODS

Hierarchical linear regressions assessed the impact of COVID-19 fears and social support on anxiety, after accounting for pre-pandemic anxiety and demographics.

RESULTS

Results supported that adding fear of COVID-19 to the regression model resulted in a significant increase in variance explained over demographics and pre-pandemic anxiety. Social support did not moderate the association between fear of COVID-19 and anxiety.

CONCLUSION

These data underscore the mental health impact of COVID-19 on students and the urgency with which campus-wide initiatives are needed to support students during this unprecedented time.

University students coping with COVID-19 challenges: Do they need help?

Objective: This study examined students' perceived levels of coping and need for help, and the relationship with their risks and protective factors during the early stages of the COVID-19 pandemic in Israel. Participants: A sample of 4,710 university students responded anonymously to an online questionnaire. Methods: The risk and protective factors assessed were: specific COVID-related functional difficulties, levels of social support, and trust in the university authorities and the government in handling the crisis. Results: The most frequent COVID-19 related difficulties were: worry for the health of family members (64.4%) and difficulties with online learning (63.2%). Almost half of the students (47.3%) reported that they needed at least a little help. Hierarchical regression analyses for coping and need for help showed that COVID-related difficulties predicted lower levels of perceived coping and a higher need for help. Conclusions: Universities need to build specific services for students to provide concrete support throughout this continuous health crisis.

Mental health impacts of the COVID-19 pandemic on college students

The COVID-19 pandemic is having profound effects on college students, and those with mental health conditions are more vulnerable to the impact of this stress. Objective: To study the impact of the COVID-19 pandemic on college students' mental health. Participants: Participants (n=489) were mostly female, undergraduate, and aged 18-25. Methods: Participants completed an online survey assessing symptoms of mental health problems including hopelessness, loneliness, sadness, anxiety, sadness, and anger. Results: Approximately 81.6 % self-reported at least one negative mental health symptom. Students reported increased feelings of hopelessness (+7.8%), loneliness (+6.7%), sadness (+8.8%), depression (+2.6%), anxiety (+5.2%), and anger (+14.6%) during the pandemic than before. LGBTQ students and Black students had significantly more mental health symptoms during the pandemic than straight and White students. Conclusions: Results of this study highlight the negative impact of the pandemic and resultant changes on college students' mental health.

Reducing Anxiety and Enhancing Mindfulness in College Students during COVID-19 through WeActive and WeMindful Interventions

OBJECTIVE

The purpose of this study was to examine the immediate and short-term, sustained effects of two virtual interventions, WeActive, an aerobic and resistance training program, and WeMindful, a mindful exercise, in reducing anxiety and improving mindfulness among college students during the COVID-19 pandemic.

METHODS

Participants were 60 students from a large Midwestern university who were randomly assigned to either the WeActive group (n = 36) or the WeMindful group (n = 24). The WeActive group participated in two virtual 30 min aerobic and resistance training sessions per week (WeActive) and the WeMindful group participated in two virtual 30 min mindful exercise sessions per week for eight weeks. All participants completed the Generalized Anxiety Disorder scale and the Five Facet Mindfulness Questionnaire through Qualtrics at three time points: one week prior to (pre-test), one week after (post-test), and six weeks after (follow-up) the intervention.

RESULTS

A repeated-measures ANOVA revealed a significant main effect of time on anxiety (F = 7.51, η2 = 0.036, p = 0.001) in both groups. WeActive significantly decreased anxiety scores between the pre-test and follow-up (t = 2.7, p = 0.027) and post-test and follow-up (t = 3.1, p = 0.007), and WeMindful significantly decreased anxiety scores between the post-test and follow-up (t = 0.641, p = 0.028). For mindfulness, there was a significant main effect of time in both groups (F = 3.91, η2 = 0.009, p = 0.025), where only WeMindful significantly increased mindfulness from the pre-test to follow-up (t = -2.7, p = 0.025).

CONCLUSIONS

Anxiety decreased significantly in both the WeActive and WeMindful groups and mindfulness increased significantly in the WeMindful group. Furthermore, the decrease in anxiety was sustained in a short-term period following the end of the intervention.

Relationships between grit and lifestyle factors in undergraduate college students during the COVID-19 pandemic

Objective: To investigate the influence of grit on physical activity, sleep and diet in undergraduate students during the COVID-19 pandemic. Participants: 125 undergraduate students participated in the study. Participants completed an online survey while enrolled in an online class during June, 2020. Methods: The online questionairre featured the following validated survey instruments: International Physical Activity Questionnaire Short Form, Pittsburgh Sleep Quality Index, the Rapid Eating Assessment for Participants Short Form and the grit short form. Effects of grit on lifestyle behaviors were explored using several statistical approaches. Results: We found that individuals with more grit reported better eating and sleeping behaviors compared to those with less grit. However, we did not find an influence of grit on physical activity or sitting time. Conclusion: Our findings support that personality traits encompassed in grit contribute to college students reporting healthier dietary habits and better sleep quality during a global pandemic.

Development of an mHealth text message intervention to promote adherence to COVID-19 isolation recommendations for college students

Background: Important tools in preventing the spread of COVID-19 include contract tracing and adherence to isolation guidelines after a positive diagnosis of COVID-19. This is especially relevant among college students who are often away from support systems at home, living in high-density housing, and may not experience serious symptoms from COVID-19 while still contagious. Objective: As text message-based interventions have been found effective in addressing health behaviors among young adults, we conducted formative research to explore how text messaging could support students in adhering to isolation guidelines. Participants: A convenience sample of college students (n = 104) at one university. Methods: An online survey gathered students' perceptions of helpful components to include in a text message-based intervention. Results: Students expressed interest in receiving text messages with support, encouragement, and resources during their time in isolation following a COVID-19 diagnosis. Conclusions: Based on the results, we developed a text message-based intervention designed to provide motivation, support, distraction, and information on resources.

Risk factors for increased alcohol consumption among young adults during COVID-19

Objective: This study explored correlates of increased alcohol use among a predominantly low-socioeconomic status student population at two time points during the COVID-19 pandemic. Participants: Participants were students enrolled in at least one course at a City University of New York (CUNY) campus. Methods: Demographic characteristics, stressor endorsements, probable diagnoses, and alcohol use endorsement, were collected via self-report surveys in April and July 2020. Frequencies and multivariable logistic regressions were computed to assess for prevalence and odds of increased alcohol consumption. Results: High cumulative stress was significantly related to increased alcohol use in both April and July 2020. A greater number of specific stressors was associated with increased alcohol use in April as compared to July. Probable diagnoses of depression and anxiety were associated with higher odds of alcohol consumption at both time points. Conclusion: Findings highlight the importance of stress and mental health on increases in alcohol use for public university students.

The experiences and impact on wellness among international students in the United States during the COVID-19 pandemic

Objective Assessing experiences and impact on wellness among international students during the COVID-19 pandemic. Participants: 405 undergraduate and graduate international students from 65 countries studying at a large public university. Methods: An online, voluntary and anonymous survey consisting of 50 quantitative and qualitative questions was conducted through Qualtrics. Descriptive and frequency analyses were used. Results: 27% of the students had concerns about the changes in student visa status that could seriously disrupt their studies in the U.S. 66.2% of them reported a moderate level, 18.8% reported a high level of stress related to the pandemic. Students identified the highest confidence in getting tested for infection but the lowest confidence in getting treatment if infected. They preferred telehealth for mental health services. Conclusions: Universities can best help international students by assisting with student visa and international travel issues, access to treatment for COVID-19 infection and developing telehealth for mental health services.

Psychological predictors of physical activity intensity among college students

Objective: The purpose of this study was to investigate the association of mental health, subjective well-being, and the impact of COVID-19 on quality of life with PA intensity among college students. Participants: The sample included 1262 college students from a large Midwestern research university (mean age = 21.5 ± 3.6 years). Methods: Participants voluntarily and anonymously completed the Qualtrics questionnaires which included the Patient Health Questionnaire -Anxiety and Depression Scale, the Satisfaction with Life Scale, the Impact of COVID-19 on Quality of Life (QoL) Scale, and the International Physical Activity Questionnaire. Results: Multiple linear regression models indicated that COVID-19 QoL and life satisfaction were significant predictors of the total, vigorous, and moderate PA (p's < .05). Life satisfaction was also a significant predictor of walking. Conclusion: Higher level satisfaction and lower impact of COVID-19 on quality of life were related to higher total, vigorous, and moderate PA levels.

Coping with COVID-19: a snapshot of college student mental health, coping, and expectancies during stay-at-home orders

OBJECTIVE

The COVID-19 pandemic has disrupted people's lives around the world, including college students. This cross-sectional study aimed to 1) describe psychological distress, coping, and expectancies of undergraduates during COVID-19 "stay-at-home" orders and 2) examine the associations among these variables.

PARTICIPANTS AND METHODS

Midwestern US undergraduates (N = 186) completed measures of psychological distress, coping behaviors, and expectancies in March-April 2020 during the initial round of "stay-at-home" orders.

RESULTS

Students engaged in approach coping and disease prevention behaviors and had low expectations for contracting COVID-19. Most students reported clinically significant depression or anxiety. Adherence to disease prevention behaviors was associated with less stress but more anxiety. Positive expectancies and approach coping were associated with less distress. Avoidance coping was associated with more distress.

CONCLUSIONS

This study describes the toll that COVID-19 has had on college students. Continued attention to the mental health of college students during the pandemic is imperative.

Emotional experiences and study motivation among Italian university students during the second wave of COVID-19

Objective: This study aimed to investigate the relationships between emotional experiences and study motivation in a group of nonworking and never-infected university students, during the second wave of the COVID-19 pandemic. Participants: Participants (N = 353; aged M = 21.5; SD = 2.8) were mostly female (76.2%) Italian university students. Methods: They completed an online assessment that included self-report measures of fear during the second wave of the COVID-19 pandemic, intolerance of uncertainty, optimism, and study motivation. Results: Our findings showed that older students were more optimistic than younger students. Besides, fear of COVID-19, intolerance of uncertainty, and pessimism predicted worse study motivation. Conclusions: Greater psychological support should be reserved for younger students to prevent emotional experiences that might affect the learning goal.

Locus of control and pre-pandemic depressive symptoms relate to psychological adjustment of college students to the COVID-19 pandemic

OBJECTIVE

The current study examines the relationships between change in depressive symptoms and locus of control orientations among college students during the COVID-19 pandemic. Participants: A sample of 341 undergraduate students were recruited from a large Midwestern United States university.Methods: Participants completed an online cross-sectional survey with self-report measures of current depressive symptoms, retrospective pre-pandemic depressive symptoms, and locus of control.Results: Depressive symptoms changed significantly during the COVID-19 pandemic (t(340) = 7.49, p < 0.01). Pre-pandemic depressive symptoms predicted symptom change with the greatest changes among students who had fewer pre-pandemic symptoms (b = -0.58, p < 0.01) and higher external locus of control orientation (b = 0.24, p < 0.01).Conclusions: An increased presence of mental health resources is needed on college campuses and external locus of control should be targeted through clinical intervention as a risk factor for adverse depressive responses to stressors among college students.

Mental health disturbance in preclinical medical students and its association with screen time, sleep quality, and depression during the COVID-19 pandemic

BACKGROUND

Affected by various hurdles during COVID-19, preclinical medical students are at an elevated risk for mental health disturbances. However, the effects of modern mental health problems on preclinical medical students have not been adequately researched. Thus, this study was aimed to identify the proportions and implications of current mental health problems for depression, sleep quality and screen time among Indonesian medical preclinical students during the COVID-19 pandemic.

METHODS

This cross-sectional study was conducted using crowdsourcing between October 2020 and June 2021. During the study period, 1,335 subjects were recruited, and 1,023 datasets were identified as valid. General Health Questionnaire-12 (GHQ-12) was used to measure current mental health disturbances (categorized as without current mental health disturbances, psychological distress, social dysfunction, or both). The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression, the Pittsburgh Sleep Quality Index (PSQI) was employed to assess sleep quality, and a questionnaire devised for this study was used to assess screen time length per day. Multivariate data analysis was conducted using SPSS version 24 for Mac.

RESULTS

According to the findings, 49.1% of the 1,023 participants had current mental health disturbances: 12.8% had psychological distress, 15.9% had social dysfunction, and the rest (20.4%) had both psychological distress and social dysfunction. The statistical analysis provided strong evidence of a difference (p < 0.001) between the medians of depression and sleep quality with at least one pair of current mental health disturbance groups, but the difference for screen time was not significant (p = 0.151). Dunn's post-hoc analysis showed that groups without current mental health problems had significantly lower mean ranks of depression and sleep quality compared to groups that had current mental health problems (p < 0.001).

CONCLUSION

Current mental health disturbances during the COVID-19 pandemic were significantly associated with preclinical medical students' depression and sleep quality in preclinical medical students. Thus, mental health programs for this specific population should be tailored to integrate mindfulness therapy, support groups, stress management, and skills training to promote mental wellbeing.

Personalized Virtual Reality Compared With Guided Imagery for Enhancing the Impact of Progressive Muscle Relaxation Training: Pilot Randomized Controlled Trial

BACKGROUND

Empirical evidence has shown that virtual reality (VR) scenarios can increase the effects of relaxation techniques, reducing anxiety by enabling people to experience emotional conditions in more vivid settings.

OBJECTIVE

This pilot randomized controlled study aims to investigate whether the progressive muscle relaxation technique (PMRT) associated with a personalized scenario in VR promotes psychological well-being and facilitates the recall of relaxing images more than the standard complementary intervention that involves the integration of PMRT and guided imagery (GI).

METHODS

On the basis of a longitudinal, between-subject design, 72 university students were randomly exposed to one of two experimental conditions: (1) standard complementary procedure (PMRT and GI exposure) and (2) experimental procedure (PMRT and personalized VR exposure). Individuals were assessed by a therapist before and after 7 training sessions based on measures investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data were also collected.

RESULTS

Differences in changes between the 2 groups after the in vivo PMRT session conducted by the psychotherapist (T1) were statistically significant for state anxiety (F1,67=30.56; P<.001) and heart rate (F1,67=4.87; P=.01). Individuals in the VR group obtained lower scores both before (t67=-2.63; P=.01; Cohen d=0.91) and after (t67=-7.23; P<.001; Cohen d=2.45) the relaxation session when it was self-administered by participants (T2). A significant reduction in perceived state anxiety at T1 and T2 was observed for both groups (P<.001). After the VR experience, individuals reported feeling higher engagement in the experience than what was mentioned by participants in the GI group (F1,67=2.85; P=.03; ηp2=0.15), and they experienced the environment as more realistic (F1,67=4.38; P=.003; ηp2=0.21). No differences between groups regarding sense of presence were found (F1,67=1.99; P=.11; ηp2=0.11). Individuals exposed before to the VR scenario (T1) referred to perceiving the scenario recalled in-imagination at T2 as more realistic than what those in the GI group experienced (F1,67=3.21; P=.02; ηp2=0.12). The VR group had lower trait anxiety levels than the GI group after the relaxation session during session 7 (T2; t67=-2.43; P=.02).

CONCLUSIONS

Personalized relaxing VR scenarios can contribute to improving relaxation and decreasing anxiety when integrated with PMRT as a complementary relaxation method.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05478941; https://classic.clinicaltrials.gov/ct2/show/NCT05478941.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/44183.

Levels of depression, anxiety and subjective happiness among health sciences students in Croatia: a multi-centric cross-sectional study

BACKGROUND

Previous studies have shown that symptoms of depression and anxiety were highly prevalent among health sciences students. This may lead to other professional and personal difficulties and a decrease in individuals' well-being. This study aimed to analyze levels of depression, anxiety and subjective happiness among health sciences students in Croatia.

METHODS

We conducted a cross-sectional study in 10 higher education institutions in Croatia during March 2023. Eligible participants were health sciences students. Participants filled out an online survey consisting of sociodemographic questions and validated scales for determining the levels of depression (9-question Patient Health Questionnaire, PHQ-9), anxiety (General Anxiety Disorder 7-item scale, GAD-7), and happiness (Subjective Happiness Scale, SHS).

RESULTS

Of 7460 invited students, 2137 students participated in the study (29% response rate). There were 41.4% of students that exhibited at least mild depressive symptoms, with 8% of students exhibiting moderately severe symptoms and 1.8% severe depressive symptoms. Mild anxiety was found in 36.8%, moderate anxiety in 23.9% and severe anxiety in 15.8% of students. The median SHS score was 19 (15.25-22). Women students had significantly higher levels of depression (p < 0.001) and anxiety (p < 0.001) than their men peers. Students in earlier study years showed higher levels of depression, anxiety and lower levels of subjective happiness compared to those in later study years. Students with lower self-assessed financial status had higher levels of depression (p < 0.001) and anxiety (p < 0.001). Students that failed an academic year had higher levels of depression (p < 0.001), but lower levels of anxiety (p = 0.005).

CONCLUSION

In this study, we have shown that health sciences students exhibit high levels of depression and anxiety, at rates exceeding those in the general population reported in other studies. Our results may help educational institutions to put greater effort into the battle against mental health stigma, foster acceptance of mental health issues and encourage students to seek help when needed. Adequate mental health services are needed at universities to promote timely diagnosis and treatment of mental health problems.

Depression and Anxiety of Portuguese University Students: A Cross-Sectional Study about Prevalence and Associated Factors

Background

The mental health of university students has worsened over time, and it is young people who have suffered the most from the COVID-19 pandemic in terms of mental health. Anxiety and depression are the most common symptoms reported by university students and are often the cause of disabilities, either in academic performance or in other spheres of life.

Aim

The aim of this study was to both assess the prevalence of depressive and anxiety symptoms in Portuguese university students and analyze the factors associated with these symptoms.

Methods

A quantitative cross-sectional study with a sample of 3,399 university students from seven Portuguese higher education institutions was conducted. The following questionnaires were used: the generalized anxiety disorder assessment scale (GAD-7), the patient health questionnaire (PHQ-9), and a study-created sociodemographic questionnaire. The Kendall correlation coefficient, chi-square test of independence, Spearman correlation coefficient, Shapiro-Wilk test, Mann-Whitney-Wilcoxon test, and Kruskall-Wallis test were used to analyze the association between variables. The statistical analysis was done using the software R Statistics (Version 4.0.4), using a significance level of 0.05.

Results

Mild to severe anxiety symptoms were reported by 75% of the participants, and 61.2% described mild to severe depressive symptoms. Of the sample, 19.5% reported a previous diagnosis of a mental disorder, with 38.7% diagnosed after the pandemic began. Additionally, 23% reported taking medication for mental health issues, and 26.7% had considered self-harm or harbored thoughts of being "better off dead." The study found lower anxiety and depressive symptoms (p < 0.05) among men, students with higher socioeconomic status, those who frequently traveled home, individuals without prior mental health diagnoses, those with better academic performance, and those who avoided substances like coffee, tobacco, cannabis, and other illegal psychoactive substances. Interestingly, students in romantic relationships exhibited more anxiety symptoms (p < 0.05). Moreover, participants who believed they had experienced moral or sexual harassment displayed higher levels of anxiety and depressive symptoms (p < 0.001).

Conclusions

There was a decrease in the mental health of university students after the pandemic compared to prepandemic studies, and the proportion of students with anxiety and depressive symptoms was alarming. There is an urgent need to implement programs in universities to promote students' mental health.

Perceived discrimination, anxiety and mood disorders among university students during the COVID-19 era: evidence from a cross-sectional survey in a Ghanaian public university

Introduction

Before 2020 and the advent of the COVID-19 pandemic, mental disorders, including anxiety and mood disorders, were considered the leading causes of the global disease burden. There is evidence from multiple countries and social contexts that suggest the high risk of anxiety and mood disorders among students. Yet, there is a knowledge gap concerning understanding the association between the experience of discrimination and the risk of anxiety and mood disorders. We examined the association between the experience of discrimination and the risk of anxiety and mood disorders among university students.

Methods

This study is a cross-sectional survey among university students in Ghana. A quota sampling technique was used to recruit 1,601 students. Data were collected using structured questionnaires. All data were analyzed using Stata. Binary logistic regression model was used to examine the significant association between the outcome variable and the explanatory variables.

Results

The prevalence of anxiety disorder among the respondents was 67 per cent. Students who had experienced discrimination or had any member of their family experienced discrimination had higher odds (OR = 4.59, Cl = 2.64, 7.96) of anxiety and mood disorder compared to those who had not experienced any form of discrimination. Respondents aged 20-24 years had higher odds (OR = 1.47, Cl = 1.16, 1.85) of anxiety and mood disorder than those aged 15-19. Students with a high perceived risk of contracting COVID-19 had a higher odd (OR = 1.52, CI = 1.10, 2.10) compared to those with a low perceived risk.

Conclusion

The findings underscore a need for university authorities to lay out clear initiatives that will reinforce and meet the mental health needs of university students during and after periods of crisis, such as returning from COVID-19 lockdown. There must be a conscious effort to advocate and raise students' awareness of anxiety disorders. Also, it is imperative to create support groups within the university set up to address the mental health needs of all students. Younger students should be the primary focus of these interventions.

Impact of the Covid-19 pandemic and lockdowns on the education and mental health of physiotherapy students in France: a descriptive cross-sectional study with national online survey

OBJECTIVE

To determine the impact of the SARS-CoV-2 (COVID-19) pandemic and lockdowns on the mental health status, training, perceptions of the physiotherapy profession, and career plans of French physiotherapy students.

DESIGN

A descriptive cross-sectional study was conducted, representing the first and only survey of its kind, using a national online survey.

SUBJECTS

A total of 2678 French physiotherapy students participated in the study.

METHODS

Mental health status was assessed using the validated French versions of established depression, anxiety, and insomnia scales.

RESULTS

The survey revealed that female sex, age below 21 years, living alone, and having a psychiatric history or COVID-19 risk factors were associated with more severe symptoms of depression, anxiety, and insomnia in the surveyed students. In addition, stress, anxiety, and depression induced by the COVID-19 crisis were linked to apprehension about continuing practical training in physiotherapy. These factors also affected students' perceptions of the profession and the initially envisioned mode of practice, particularly among fifth-year students (odds ratio (OR) = 2.25, 95% confidence interval (95% CI) = (1.69, 2.99), p < 0.001). Notably, the pandemic significantly reduced the desire of these students to pursue a career as physiotherapists (adjusted OR (aOR) 1.41 (1.06, 1.86)).

CONCLUSION

French physiotherapy students, especially those in their fifth year, have experienced significant impacts from the COVID-19 pandemic, affecting their mental health, education, perceptions of the physiotherapy profession, and career plans.

The impact of the COVID-19 pandemic on academic performance: a comparative analysis of face-to face and online assessment

Introduction

Survey studies yield mixed results on the influence of the COVID-19 pandemic on academic performance, with limited direct evidence available.

Methodology

Using the academic platform from the Italian university system, a large-scale archival study involving 30,731 students and 829 examiners encompassing a total of 246,416 exams (oral tests only) to scrutinize the influence of the COVID-19 pandemic on the likelihood of passing exams was conducted. Examination data were collected both in face-to-face and online formats during the pandemic. In the pre-pandemic period, only face-to-face data were accessible.

Results

In face-to-face examination, we observed a lower probability of passing exams during the pandemic as opposed to pre-pandemic periods. Notably, during the pandemic we found an increased chance of passing exams conducted through online platforms compared to face-to-face assessments.

Discussion and conclusions

These findings provide the first direct evidence of an adverse impact of the COVID-19 pandemic on academic performance. Furthermore, the results align with prior survey studies underscoring that using telematics platforms to evaluate students' performance increases the probability of exam success. This research significantly contributes to ongoing efforts aimed to comprehend how lockdowns and the widespread use of online platforms impact academic assessment processes.

The role of physical literacy and mindfulness on health-related quality of life among college students during the COVID-19 pandemic

This study aimed to examine the role played by the physical literacy and mindfulness in the health-related quality of life (QoL) of college students. In early 2022, 24,236 college students from three universities in southern China were recruited in the study. R software and the lavvan package was utilized to build the structural equation model. The measurement model was composed of three latent factors (physical literacy, mindfulness, and quality of life) and 16 observed variables in total. The results of the measurement model indicated goodness fit with p > .05 in Chi-square result, and GFI = .92. In addition, the comparative fit index (.92), Tucker-Lewis index (.91), root-mean-square error of approximation (.07), and root of mean square residual (.11) were in accord with the cutoff model-fit criteria. The results confirm that physical literacy and mindfulness can play a significant and positive role in the structural equation model of quality of life. In addition, this study provides initial evidence that mindfulness and physical literacy could potentially buffer declines in student QoL during the COVID-19 pandemic. Moreover, this study is the first to develop a structural equation model of QoL with multiple indicators, making it a strong addition to existing research on QoL during a pandemic.

Mental workload, musculoskeletal discomfort and physical activity level in master's degree students in the COVID-19 context: A pilot study

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has led to a change of pedagogical strategies from on-campus to "online" modality (synchronous and asynchronous learning) and may influence the health of university students, including their mental workload.

OBJECTIVE

To identify the association between mental workload, perception of musculoskeletal discomfort (MSD), and the level of physical activity of Masters's students' online learning due to the pandemic.

METHOD

This was a pilot descriptive study with a cross-sectional, quantitative, non-experimental study design. The sample consisted of 20 students. To collect the data, the participants answered a sociodemographic questionnaire, NASA-Task Load Index, International Physical Activity Questionnaire, and the Nordic Musculoskeletal Questionnaire.

RESULTS

The students presented mental workload at medium (45%) and high (55%) levels, with time demands as the most prevalent dimension. In addition, 80% of the students reported experiencing MSD in the last seven days, with the most frequent areas being the neck and lower back. Regarding the level of physical activity, five students had a low level (25%), five students had a medium level (25%), and ten students had a high level (50%) of activity.

CONCLUSION

Most of the students (95%) conduct their master's degree along with maintaining a full-time job. Therefore, the adaptive requirements according to "time demands" is a negative factor because of its contribution to mental workload. Especially in addition to students' perception of musculoskeletal discomfort, organizational aspects would be fundamental to prevent physical and mental health risks.

Undergraduate Student Stress, Sleep, and Health Before and during the COVID-19 Pandemic

Before the COVID-19 pandemic, undergraduate students experienced sleep problems and mental health issues that were negatively associated with academic achievement. Studies comparing undergraduate sleep and health pre- to mid-pandemic have yielded mixed results, necessitating additional research on other cohorts and examination of potential moderators. The present study was conducted to examine whether American undergraduate students tested mid-pandemic experienced poorer sleep, health, and academic achievement relative to students tested pre-pandemic, as well as to examine whether poor sleep during the pandemic was preferentially associated with poorer health in women. The current cross-sectional study included 217 participants tested pre-pandemic (February-December 2019) and a separate sample of 313 participants tested mid-pandemic (November-December 2020). Participants in both samples provided demographic information and completed questionnaires inquiring about participant sleep quality, insomnia, and cumulative grade point average (GPA); participants in the mid-pandemic sample also reported on measures of general, physical, and mental health. Participants tested mid-pandemic reported poorer global sleep quality, greater insomnia severity, greater stress, and higher cumulative GPAs relative to participants tested pre-pandemic. For the mid-pandemic sample only, poorer sleep quality was associated with reduced physical health; interactions indicated that women with poor sleep quality reported poorer mental health relative to both women with good sleep quality and men with poor quality sleep. Perceived stress mediated the association between sleep problems and GPA. These findings indicate that the pandemic negatively impacted the functioning of undergraduate students and highlights the need for future studies examining additional moderators of the reported effects.

Changes in lifestyle and physical and mental health related to long-confinement due COVID-19: a study during the first and second pandemic waves in Mexico and Chile

We investigate changes in lifestyle, physical, and mental health during the confinement period of the first and second waves of COVID-19, as well as their relation to sociodemographic parameters and confinement status. Sociodemographic data and information regarding changes in their lifestyle behavior and changes in body weight and physical activity (PA) were collected. The SF-36 questionnaire was implemented for measuring the domains related to physical health (PH) and mental health (MH). The growth frequency of weight gain in the Mexican (4.8%) and Chilean (10.9%) populations was observed during the second wave. The MH component decreased in the Mexican and the Chilean population (p < 0.05). Moreover, the MH decreased significantly according to the degree of confinement (p < 0.01). Although some sociodemographic factors were related to the presence of a very low score (<50 scores) for the MH component during the first wave, it is perceived as a higher relative risk during the second wave in both populations. The long confinement due to COVID-19 is associated to negative changes in nutritional and physical lifestyle behavior, affecting mainly the MH component.

College students' perceptions of COVID-19 conversations on social media

Objective: This project assessed college students' perceptions of social media conversations about COVID-19 in the United States. Participants: A total of 110 college students completed an online survey (N = 110) over two periods of time: April 2020 (n = 60) and September 2020 (n = 50). Method: Measurements included students' perceptions of sentiment, risk, blame, outrage, and opinion/behavioral intention. Results: Survey results showed that college students' attitudes and perceptions of these concepts on social media varied from April to September with negative sentiment, concern, uncertainty, and risk perception decreasing over time while blame and outrage increased over time. A sample of tweets was also examined for these constructs. Conclusions: This study provides important insight on college students' perceptions during a public health emergency and how they use social media as a tool for health information.

COVID-19 Pandemic: What We Have Learned on Stress, Technology Use, and Psychological Health Among University Students

Nowadays, the medical COVID-19 emergency is ending worldwide, whereas there is an increasing need to understand the marks and the lessons learned from over two years of unprecedented changes in all life domains. Recent research has highlighted growing rates of psychological suffering among the general population as well as among university students, who were yet well-recognized as a vulnerable population even before the pandemic. The present work drives from university students' experience, and it aims to provide an overview of the key dimensions to take into account, in terms of main risks, changes, challenges, and resources, to develop updated tailored research and interventions promoting psychological health conditions in the current time within and beyond the educational context/university students' population. Implications for research and interventions are highlighted and discussed.

A cross-sectional study on the role of computer anxiety in students' online learning

Introduction

Although e-learning has been incorporated in higher education system, students may undergo negative emotions like anxiety using this new mode of learning which ultimately interfere with their learning performance. Hence, the current study aimed to examine the role of computer anxiety in students' online learning.

Methods

This is a cross-sectional correlational study, in which a convenient sample of 330 students of Shiraz University of Medical Sciences participated. To collect the data, we used two pre-validated questionnaires. Face, content, and construct validity were used to check the validity of the questionnaires. Cronbach's alpha and composite reliability were also used to check the reliability. Data were analyzed using SPSS 16 and AMOS 6.

Results

Confirmatory factor analysis results yielded the underlying factorial structure of the scales. In addition, correlation coefficient results indicated that there was a significantly negative relationship between students' computer anxiety and their online learning (r=-0.59, p<0.001).

Conclusion

The results of the present study revealed that a considerable number of students experienced some level of computer anxiety, highlighting that highly anxious students face negative consequences such as inadequate online learning.

Assessment of psychological distress as a function of positive psychological variables during the COVID-19 pandemic: A university longitudinal study

Objective: To examine changes in psychological distress of college students as a function of demographic and psychological variables over time during the COVID-19 pandemic. Participants: Subjects were recruited from a large public university in Northeast Ohio using electronic surveys administered at three time points in 2020. Methods: Demographics, positive psychological metrics (flourishing, perceived social support, and resilience) and psychological distress were collected and a mixed linear model was run to estimate their effect on change in distress. Results: Psychological distress did not change significantly across time. Females experienced more psychological distress than males. Higher levels of flourishing, perceived social support, and resilience were associated with less distress overall. Conclusions: Although psychological distress did not change across observed time, previous data suggests heightened psychological distress that remained elevated across observed time during the COVID-19 pandemic. Positive psychological variables were shown to mitigate psychological distress, and the relationship was stable over time.

Anxiety and depression among US college students engaging in undergraduate research during the COVID-19 pandemic

OBJECTIVE

The objective was to examine mental health of undergraduate researchers (UGRs) during the COVID-19 pandemic.

PARTICIPANTS

We surveyed 962 UGRs who were conducting research in Spring 2020 at over 100 US universities.

METHODS

We conducted an online survey in July 2020. We analyzed data using descriptive statistics and multivariable generalized estimating equations.

RESULTS

63% reported at least mild anxiety and 73% reported at least mild depression based on GAD-7 and PHQ-9 scores; 15.2% reported severe anxiety (score ≥ 15) and 23.4% reported severe depression (score ≥ 15). More COVID-19-related adverse event experiences were associated with more severe anxiety and depression, as were first-generation status, woman gender, and LGBQ status. Greater social support was protective, and significantly more so for men (vs. women) and continuing generation (vs. first generation) students.

CONCLUSION

Faculty have an important role in the mental health of their mentees. Additional interventions are needed to better support women and first-generation students.

Supplemental data for this article can be accessed online at.

COVID-19 Experiences and Mental Health Among Graduate and Undergraduate Nursing Students in Los Angeles

BACKGROUND

Nurses and nursing students are at risk for negative mental health as a result of significant work stressors from the COVID-19 pandemic.

AIMS

The purpose of this study was to (1) describe the mental health of nursing students during the COVID-19 pandemic, (2) investigate relationships between stressful COVID-19 experiences and mental health, and (3) examine correlates of mental health service use.

METHOD

This observational study used a web-based survey to assess COVID-19 experiences, self-reported mental health, and mental health service utilization among nursing students in Los Angeles in spring 2021 (N = 174, 30.1% response rate). The survey used measures of stressful COVID-19 experiences (personal COVID-19 illness, hospitalization of close friends or family, and death of close friends or family), loneliness, resilience, depression, anxiety, COVID-19-related traumatic stress, and utilization of campus and noncampus mental health services.

RESULTS

Students had high levels of depression (30%), anxiety (38%), and traumatic stress (30%). There was no relationship between stressful COVID-19 experiences and mental health, but loneliness was associated with higher odds of mental health problems and resilience with lower odds. Mental health problems were not associated with use of campus or noncampus mental health services. Students with primary caregiving responsibilities (OR = 0.22, 95% CI [0.05, 0.87]) and students who identified as Asian/Pacific Islander (OR = 0.24, 95% CI [0.09, 0.70]) had lower odds of mental health service utilization.

CONCLUSIONS

Resilience and loneliness affect nursing student risk for negative mental health as a result of the COVID-19 pandemic. Targeted, accessible mental health support within nursing education programs may be warranted.

Perceptions of mental health and need satisfaction/frustration among rural university students

OBJECTIVE

Because of COVID-19, higher education changed as institutions went remote and students' mental health was challenged. Rural universities were disproportionately affected because of limited Internet access. The purpose of this study was to investigate the psychological need satisfaction/frustration and mental health among rural college students during this pandemic.

PARTICIPANTS

Six hundred ninety-eight students (Mage = 22.15 ± 2.55) at a rural South-eastern university were recruited.

METHODS

Participants completed a survey examining stress, anxiety, need satisfaction/frustration and previous experience with online courses.

RESULTS

Anxiety, autonomy and competence frustration were found to predict 60% of the variance of stress. Another regression analysis found stress, autonomy, competence, and relatedness frustration to predict 70% of the anxiety variance.

CONCLUSIONS

Students are frustrated due to the lack of control and restrictions affecting their social interaction. Understanding the relationship between need satisfaction/frustration and mental health can aid university administration in developing interventions that address rural students' needs.

The Impact of Aromatherapy Gelatin Cold Compresses on the Concentration Level of Students in the Covid-19 Pandemic Online Class

Introduction

Stressful circumstances presented by the Covid-19 pandemic led to reduced levels of study concentration among students, and these conditions had been linked with dopamine levels.

Objectives

This study aimed to evaluate the impact of aromatherapy gelatin cold compress in increasing the study concentration of students by decreasing stress levels and elevating dopamine levels during the Covid-19 pandemic online class.

Methods

The study participants consisted of 42 students, who were selected using the simple random sampling method. Subsequently, the participants were comparably divided into control and treatment groups. Compress intervention was given to the treatment group on the forehead for 10 min before studying online. The Visual Analog Scale (VAS) and Stroop test were then used to determine stress and concentration levels of the students, respectively. The catecholamine fractionated urine was used to measure dopamine levels. Analysis was carried out using Paired T-test and Independent T-test with α = 0.05 and CI = 95%.

Results

The mean value of the VAS before and after treatment was 5.81 ± 2.48 and 5.28 ± 2.61 in the control (p = 0.205), as well as 6.28 ± 1.62 and 4.38 ± 1.89 in the treatment group (p = 0.000). The mean interference score of the Stroop test before and after treatment was 13.16 ± 1.05 and 13.22 ± 1.31 among the controls (p = 0.947), while 13.35 ± 6.94 and 8.92 ± 5.91 were recorded in the treatment group (p = 0.000). The average dopamine levels before and after the intervention were 145.50 ± 7.94 mg/mL and 146.65 ± 8.23 mg/mL creatinine among the controls (p = 0.542), while 145.35 ± 1.03 mg/mL and 265.18 ± 1.27 mg/mL creatinine were obtained in the treatment group (p = 0.01). Furthermore, the results showed that the creatinine levels were within the normal ranges. The Independent T-test of stress, concentration, and dopamine levels obtained p = 0.024, p = 0.010, and p = 0.090, respectively.

Conclusion

Aromatherapy gelatin cold compress was effective in increasing study concentration by decreasing stress levels and increasing dopamine levels during the Covid-19 pandemic online class.

Associations of adolescent substance use and depressive symptoms with adult major depressive disorder in the United States: NSDUH 2016-2019

BACKGROUND

Few studies have focused on the associations of adolescent substance use and depressive symptoms with adult major depressive disorder (MDD).

METHODS

Data from 168,859 adults, among which, 15,959 had experienced MDD in the past year, as indicated by a major depressive episode (MDE) marked by MDD symptoms, were from the 2016-2019 National Surveys on Drug Use and Health. Weighted multivariable logistic regression (MLR) analyses were used to determine the associations.

RESULTS

The overall MDD prevalence was 7.2 %, whereas the prevalence for adults without early onset depressive symptoms prior to age 18 was 4.6 %. Variable cluster analysis revealed that adolescent use of alcohol, cigarettes, marijuana, cocaine, hallucinogen use, and inhalants prior to age 18 were in one cluster. MLR analyses showed that the presence of depressive symptoms prior to age 18 was the major risk factor for MDD, while adolescent use of alcohol, marijuana, and inhalants prior to age 18 were associated with increased odds of MDD (p < 0.05) both in the whole data and the subset of adults without depressive symptoms prior to age 18. Adolescent use of cocaine prior to age 18 were associated with MDD only in the whole data, whereas adolescent smokeless tobacco use was associated with MDD only in those without depressive symptoms prior to age 18.

CONCLUSIONS

These findings highlight the comorbid early substance use and depressive symptoms during adolescence with adult MDD. Intervention strategies should simultaneously address early-onset substance use and depressive symptoms prior to age 18.

The Impact of COVID-Related Restrictions on the Mental Health of Students

The first stage of the COVID pandemic in spring and early summer of 2020 was shaped by restrictions due to the so-called flattening-the-curve approach. Students globally were impacted when public and private colleges and universities were forced to either shut down temporarily or transition to remote learning. Studies from around the world found increased levels of stress, anxiety, depression, and suicidal ideation. Female students often reported being more affected than male students. Suicide rates, however, did not increase. The second stage, starting in late summer 2020, saw the highest case numbers but also a slow and mostly partial return to normal life enabled by vaccination efforts and policy decisions. The mental health of students in most countries recovered well, even when they had to go through repeated or continued lockdowns or restrictions. Although it cannot be predicted what portion of students will be affected by mental health issues in ten or twenty years, it is certain that there will be long-term mental health consequences for many. It is also uncertain which approach, "living with COVID" or "zero COVID," will show less impact on the mental health of students' long term.

Resilience of University Students During the Coronavirus Disease 2019 Pandemic and Results of a Pilot Positive Psychotherapy Intervention Study

Objective

University students were significantly affected by the 2019 coronavirus disease pandemic, with significant impacts on their mental health, resilience skills, and life skills. The primary aim of this study was to evaluate these parameters by focusing on the experiences of 472 university students as well as examining correlations between mental states, resilience, and life skills. The secondary aim was to conduct a pilot study of a 10-week psychoeducation program that uses positive psychotherapy to improve resilience skills.

Methods

The first phase of this research project was designed as a quantitative and correlative study, while the second phase was designed as a quasi-experimental model. Data collection tools used in the first phase included the Sociodemographic Information Form, Life Skills Scale (LSS), Symptom Checklist (SCL90R), and Brief Resilience Scale (BRS). The Resilience Scale for Adults (RSA) was used in the second phase. The sample group for the first phase was 472 university students from several university institutes in Cyprus, while the quasi-experimental group consisted of 33 psychology students from the University of Cyprus.

Results

The average mental symptoms score for students based on SCL90R was 1.10 ± 0.70, showing they have psychological symptoms and grievances. Significant negative correlations were found between the BRS general score and the LSS general and SCL90R scores (all P = .001). The model was found to be significant and could explain 18.5% of the effect according to the predictive status of LSS and SCL90R scores in BRS scores.

Conclusion

In conclusion, this study provides vital insights into the mental well-being of university students during the pandemic. The findings reveal a concerning prevalence of psychological symptoms and distress among students, indicating a significant impact of the COVID-19 crisis on their mental health. This research also demonstrated the effectiveness of targeted interventions. The positive changes in resilience skills and reduced mental health symptoms observed after the 10-week study period highlight the importance of proactive approaches. This study underscores the urgent need for accessible mental health resources and tailored support mechanisms for university students, especially during times of crisis. Addressing these issues is crucial for fostering a resilient and mentally healthy student population.

Effects of the COVID-19 Pandemic on Depressive Symptoms, Including Clinical and Subthreshold Levels, and Eating Behaviors in First-Year University Students

Introduction

During the coronavirus disease 2019 (COVID-19) pandemic, university students experienced unusual environmental stresses, and the number of university students with depressive symptoms increased. The pandemic had a profoundly negative impact on the mental health of first-year students because they were not prepared to face academic and social stresses. The purpose of this study was to investigate the effect of the COVID-19 pandemic on depressive symptoms, eating behaviors, and stress-coping ability among first-year university students.

Methods

A total of 8,424 first-year students, 2,043 males and 1,636 females who entered university in Japan in 2021-2022 (during the pandemic) and 2,912 males and 1,833 females who entered university in Japan in 2018-2019 (before the pandemic), participated. We investigated the differences in depressive symptoms (using Beck Depression Inventory II [BDI-II]), eating behaviors (using Eating Attitudes Test-26 [EAT-26] and Bulimic Inventory Test, Edinburgh [BITE]), and stress coping (using Coping Inventory for Stressful Situations [CISS], which has three subscales) between first-year students before and during the pandemic. We divided the students into three categories (clinical, subthreshold, and nonsymptomatic) according to depressive symptoms and eating behaviors based on BDI-ll and EAT-26 scores and compared the frequencies of the three categories at two time points.

Results

First-year students during the pandemic showed a higher percentage of depressive symptoms, including clinical and subthreshold levels, than first-year students before the pandemic but did not show disordered eating behaviors. Additionally, the CISS task-oriented score was significantly lower for students with depressive symptoms, including clinical and subthreshold levels, during the pandemic than before the pandemic in females.

Conclusions

This study suggests that it may be important to provide first-year university students with more information about depressive symptom awareness, including clinical and subthreshold levels, and to provide appropriate ways for stress coping from many angles and early support in pandemic conditions.

Flourishing (or lack thereof) during COVID-19: College students'social-psychological well-being during the Fall 2020 semester

Objective: This exploratory quantitative study examined college students' social-psychological well-being during the COVID-19 pandemic. Participants: The sample included 1,723 students (undergraduate and graduate) at a public research university. Methods: Paired samples t-test were utilized to compare students' social-psychological well-being pre-pandemic, at the start of the Fall 2020 semester, and toward the end of the Fall 2020 semester. Regression analyses were utilized to identify predictors of students' social-psychological well-being at the start and toward the end of the Fall 2020 semester. Results: Students experienced a significant decrease in social-psychological well-being pre-pandemic to the start of the Fall 2020 semester and most had not returned to pre-pandemic levels toward the end of the semester. While demographics, housing arrangements, and course modality impacted social-psychological well-being, they only explained a small percentage of the variance in students' well-being. Conclusion: Students continued to experience low mental well-being during the Fall 2020 semester.

Impact of COVID-19 on the self-esteem, psychological and dental esthetics of dental students

BACKGROUND

Coronavirus disease 2019 (COVID-19) has badly affected the mental health, quality of life, and self-esteem of students worldwide.

OBJECTIVE

The current study aimed to evaluate the psychological impact and self-esteem of dental students using Rosenberg self-esteem scale and PIDAQ during the COVID-19 pandemic.

METHOD

This cross-sectional research was conducted amongst the dental students studying at various dental colleges in Karachi, Pakistan from January to May 2022. Evaluation of psychological aspect and self-esteem of students was carried out using "Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ)", and "Rosenberg self-esteem scale" as perceived by students during the pandemic. For data analysis SPSS v24 was used. Data analysis comprised of descriptive analysis, Spearman correlation, One-way Anova and Linear regression. The level of significance of p value was less than 0.05.

RESULTS

Overall 332 students participated, among which there were 181 females (54.5%), 151 males (45.5%). Dental self-confidence showed a negative relationship with social influence, psychological effect, and aesthetic concern, while it was positively linked with self-esteem during the pandemic. Social impact demonstrated association with psychological impact, aesthetic concern, and self-esteem, while it was negatively correlated with dental confidence. Rosenberg score showed positive correlation with all the variables. Statistically significant association was identified for variables when compared with gender. Regression analysis indicated association of age with dental confidence and RSS, while gender with social influence.

CONCLUSION

The pandemic, aside from affecting the health of individuals worldwide, also badly affected the well-being, mental health, and self-esteem of the dental students. Dental aesthetics plays a crucial role in the mental wellbeing and self-esteem of the students.

Severe Loneliness and Isolation in Nursing Students during COVID-19 Lockdown: A Phenomenological Study

In 2022, COVID-19 continued to spread across the globe, and to stop the spread of the virus and protect people's health, universities across China continued to remain in a lockdown state. Loneliness is an important topic among college students, and the coronavirus pandemic has exacerbated loneliness. This prolonged school lockdown was unprecedented and it caused severe social isolation and emotional loneliness for students. Few people know how nursing students experience loneliness and find a way through their experience. This qualitative phenomenological study was conducted to reveal the lived experiences of nursing students who indicated COVID-19 lockdown-related loneliness in a previous quantitative survey. We performed 20 semi-structured interviews with nursing students aged 19-23 yrs during their lockdown (April 2022 to June 2022). Our research applied Colaizzi's seven-step data analysis processes to reveal shared patterns in terms of how nursing students experienced lockdown and found the following four themes: emotional challenges associated with loneliness; causes of loneliness; positive and negative motivation to learn; and accepting solitude and reconstructing real life.

Mediating factors explain anxiety experienced by women with obesity during the Covid-19 pandemic

The Covid-19 pandemic could be a source of great anxiety, especially for those at higher risk, such as women experiencing obesity. The aim of this study was to measure how some personal characteristics such as BMI (from underweight to class 3 obesity), bariatric surgery (yes or no), comorbidities, or age (as antecedent variables), and mediating factors impacted state anxiety during the Covid-19 Pandemic. Mediating factors were related to subjective knowledge or attitudes (e.g. interest or beliefs and practices around Covid-19, subjective health perception, and confidence in the government). French women (N = 532) were invited to take part in a voluntary online health survey during lockdown in Paris and its suburbs. Results showed that women with higher BMI had higher anxiety scores, primarily because they feel less healthy than other people. Secondly, the larger the body size of the participants was (BMI), the less they reported that information about Covid-19 held their attention. This lack of interest resulted in feelings of anxiety not being generated. Thirdly, the larger their body size was, the less confidence they had in the effectiveness of the proposed measures by the government and therefore, the more anxious they were. Finally, older age predicted higher interest in the pandemic, higher subjective health, and higher confidence in the government. Identifying obesity as a potential risk factor for anxiety disorders is crucial, but measuring the relationship between state anxiety and personal characteristics (e.g. BMI) requires considering mediating variables (e.g. subjective health perception). To reduce anxiety in women with obesity, it appears necessary to focus on psychological programs that can help them improve their perception of their health, as well as the confidence they may have in institutions, especially for younger women.