Associations Between Procrastination and Subsequent Health Outcomes Among University Students in Sweden

A network analysis of academic procrastination, psychological and environmental factors among medical students

BACKGROUND

Academic procrastination is a multifaceted phenomenon influenced by psychological and environmental factors and has potential negative academic and career consequences. However, there are no studies that have comprehensively explored the mechanisms of academic procrastination in medical students. This study conducts a network analysis of seven factors associated with procrastination, to establish a network of academic procrastination, and to explore the academic procrastination network and the relative importance of the different factors.

METHODS

A sample of 681 students (72.1% women, 27.9% men) completed self-rating questionnaires that measured fear, conscientiousness, self-efficacy, impulsivity, depression, the nature of tasks, teacher traits, and academic procrastination. Two networks were created using regularized partial correlation network analysis (EBICglasso) with scales and items as nodes respectively, to determine the role of psychological and external environmental factors in academic procrastination.

RESULTS

Both networks were linkage active, and all variables showed significant correlations. Impulsivity and depression emerged as the central and bridge components, with the highest centrality indices observed for difficulty concentrating and self-hatred. Environmental factors have the highest expected influence value in the Scale-level network and academic procrastination.

CONCLUSION

The present study shows that impulsivity and depression are key factors in academic procrastination networks in the medical student population, especially difficulty concentrating and self-hatred. It further adds the influential role played by environmental factors.

TRIAL REGISTRATION

This is an observational study based on surveys and network analysis, and no healthcare intervention was involved. Therefore, it was not registered in any clinical trial registry.

Subclinical Psychiatric Symptomatology and a Proposed Diagnostic Criterion Separating Psychopathological Procrastinators From Trait Procrastinators

Procrastination trait describes irrational delays of scheduled tasks despite clear awareness of the adverse consequences of doing so. Although procrastination is well-known to be linked to psychiatric or pathological processes, the criterion for "psychopathological procrastination" distinguishing from the procrastination trait is understudied. This is a 5-year longitudinal observational study. Participants (N = 464) completed measures of trait procrastination in 2018, with a follow-up conducted in 2023 (N = 267) collecting subclinical symptomatology. A constrained multivariate direct gradient model (cmDGM) was employed to prospectively predict subclinical psychiatric symptomatology formulated by the DSM-5 framework. The two-stage psychopathological connectome model was then constructed to constitute a "diagnostic criterion" reflecting "psychopathological procrastination." Procrastination prospectively predicted subclinical psychopathological symptoms and unhealthy lifestyles. Subclinical bridge hubs of "failure to self-regulate delays," "failure to control adverse consequences," "useless to self-change," "out-of-control irruptions," "poor sleep quality," and "negative emotional reactions" were identified in the two-stage psychopathological network. These hubs constituted the 9-item pathological procrastination diagnostic criterion (3PDC) with good diagnostic performance (AUC = 0.82, p < 0.01). The present study revealed the predictive role of procrastination for subclinical psychiatric symptomatology and further established the subclinical 3PDC to lay the foundation for the "diagnostics of psychopathological procrastinators."

The Implementation of a Blended Counseling Intervention in Undergraduate Engineering Students: The Effect on Mental Health

Background/Objectives: The accelerating global concern for the mental health of university students necessitates delivering intervention programs. The purpose of this study is to evaluate the effectiveness of a 5-week blended counseling group program, with two integrated approaches, positive psychology intervention and cognitive therapy, toward undergraduate engineering students' depression, anxiety, and stress, from the Higher School of Pedagogical and Technological Education, Greece. Methods: Participants with a mean age of 21.12 (SD = 3.68) were administered the DASS-21. A two-way repeated-measures design was used and the two factors were condition and time. The subjects underwent two conditions, the experimental (n = 40), consisting of the civil and mechanical engineers, and the control (n = 52), that encompasses the electrical engineers. The three dependent variables, DASS-21 factors, were measured at three time points, at the beginning of the program, midway through the program, and at the end of the program. Results: The effect of the interaction between time and the conditions on DASS-21 depression and stress was significant. In particular, the experimental subgroups showed lower depression and stress at the end of the program in comparison with the control group. However, they did not demonstrate significantly lower scores on anxiety. Furthermore, the two intervention subgroups did not exhibit any significant mid- and post-test differences on all measures. Conclusions: In light of the obtained results, it can be concluded that the group counseling blended cognitive positive psychology program is an effective intervention.

Behavior Change Support Systems for Self-Treating Procrastination: Systematic Search in App Stores and Analysis of Motivational Design Archetypes

BACKGROUND

The phenomenon of procrastination refers to an individual's conscious decision to postpone the completion of tasks despite being aware of its adverse consequences in the future. Extant research in this field shows that procrastination is associated with increased levels of anxiety and stress and the likelihood of developing depression and calls for the development of suitable interventions that support individuals in making lasting positive changes to their procrastination behaviors. In parallel, practice has produced a plethora of behavior change support systems (BCSSs) that aim to provide a low-threshold, accessible alternative to in-person therapeutic approaches. Most of these BCSSs can be considered motivational BCSSs that combine functional, utilitarian components with hedonic and eudaimonic design elements to empower self-treatment. Although early studies have suggested the potential benefits of such BCSSs, research on understanding their specific design characteristics and support of individuals in self-treating procrastination is still in its infancy.

OBJECTIVE

In response to this gap between practice and research, we aimed to analyze and systemize the multitude of practical design efforts in motivational BCSSs for the self-treatment of procrastination and identify the main design archetypes that have emerged.

METHODS

We conducted a 3-step research approach. First, we identified 127 behavior change support apps for procrastination through a systematic screening process in the German and US Apple App Store and Google Play Store. Second, we systematically coded the identified apps in terms of the behavior change techniques targeted by their functional design and hedonic or eudaimonic design elements. Third, we conducted a 2-step cluster analysis to identify archetypes of motivational design in behavior change support apps to combat procrastination.

RESULTS

A variety of motivational designs have been developed and implemented in practice, and our analysis identified five main archetypes: (1) structured progress monitor, (2) self-improvement guide, (3) productivity adventure, (4) emotional wellness coach, and (5) social focus companion. The identified archetypes target different psychological determinants of procrastination and successfully use a variety of hedonic and eudaimonic design elements that extend beyond the current state of research.

CONCLUSIONS

The results of our study provide a foundation for future research endeavors that aim to examine the comparative effects of motivational design archetypes and develop more effective interventions tailored to individual needs. For practitioners, the findings reveal the contemporary design space of motivational BCSSs to support the self-treatment of procrastination and may serve as blueprints that can guide the design of future systems. For individuals seeking support and health professionals treating procrastination, our study systemizes the landscape of apps, thereby facilitating the selection of one that best aligns with the patient's individual needs.

Exploring the role of perfectionism and psychological capital in the relationship between academic procrastination, test anxiety and suicidal ideation among pre-medical students

The present study explores the direct, mediating and moderating effects of perfectionism and psychological capital on the relationship between academic procrastination, test anxiety and suicidal ideation among pre medical students in Pakistan. Data was collected using a quantitative, cross-sectional research design from 920 participants attending entrance test centers in Lahore and Multan, recruited through convenience sampling. A structured self-administered questionnaire was completed by participants. Correlations, mediation and moderation effects were assessed using SPSS and the PROCESS macro. Results show a highly significant direct effect of academic procrastination and test anxiety on suicidal ideation, both of which increase students' suicidal thoughts. We found a mediating role of perfectionism whereby high perfectionistic tendencies amplified the relationship between academic procrastination and test anxiety leading to a higher likelihood of suicidal ideation. Furthermore, psychological capital was found to moderate the effect of test anxiety on suicidal ideation. These results suggest that there is a necessity of the development of interventions aiming at reduction of the indirect impact of academic procrastination on the students' psychological well-being by altering the psychological mediators. Educational institutions should begin to introduce programs revolving stress management and promotion of mental health to assist students to cope with stress, academic procrastination and perfectionism.

Teachers' academic motivation and student procrastination behaviour: mediating effects of emotion regulation and study habits

PURPOSE

The present study aimed to analyze the effectiveness of external and personal regulatory mechanisms in reducing procrastination behavior among university students. For this purpose, the role of teachers' academic motivation is worthwhile in shaping the learning environment and reducing procrastination, with a focus on the mediating roles of emotion regulation and study habits considered imperative.

RESEARCH DESIGN/METHOD

By employing a quantitative, cross-sectional research design, data were collected from a sample of 210 teachers working in universities located in Multan-Pakistan via convenient sampling, yielding a usable response rate of 70.28%.

DATA ANALYSIS & STUDY RESULTS

The gathered data was analyzed using Smart PLS 4 software. Results from the structural equation model (PLS-SEM) indicated that teachers' academic motivation significantly affects student procrastination. However, when mediated by emotion regulation and study habits, the study confirmed the statistically significant mediating effect of both mediators in mitigating procrastination among students.

FINDINGS

Findings of the present study suggested that enhancing teachers' motivation may be more effective when mediated with emotional regulation and effective study habits. Emotionally regulated students and those with effective study habits were less likely to procrastinate during their academic endeavor. The findings highlighted the need for teacher training programs to develop and promote motivation and support students' emotional and academic regulation to enhance learning outcomes.

PRACTICAL IMPLICATIONS AND RECOMMENDATIONS

Based on the above findings, the study suggested that enhancing teacher motivation is more impactful when paired with strategies to foster student emotion regulation and study habits. It also recommended educational policies prioritizing academic content and personalized student engagement strategies to minimize procrastination and promote academic success. Programs should be implemented with a focus on promoting motivation while enabling teachers to support students' emotional and self-regulatory needs for better academic outcomes.

Procrastination and preventive health-care in the older U.S. population

OBJECTIVE

Maintaining health preventive behaviours in later life reduces the risk of non-communicable diseases. However, these behaviours often require effort and discipline to adopt and may be prone to procrastination. This study examined whether procrastination affected engagement in health preventive behaviours among older adults.

METHODS

We applied generalised additive models to data from the 2020 wave of the United States Health and Retirement Study. Our analytic sample consisted of adults aged 50+ (n = 1338; mean = 68.24; range = 50-95). Our analysis focused on six health preventive behaviours: prostate exams, mammograms, cholesterol screenings, pap smears, flu shots, and dental visits.

RESULTS

Procrastination was associated with less frequent engagement in mammograms and cholesterol screenings among women, though it had no significant association with pap smears or flu shots. Additionally, procrastination interacted with depression reducing the likelihood of prostate exams in men and dental visits in both men and women, such that individuals with high procrastination and low depression were associated with less frequent engagement in both preventive health behaviours.

CONCLUSIONS

Procrastination may be a behavioral risk factor for maintaining optimal health in older adults. Given that procrastination is a potentially modifiable behaviour, interventions aimed at reducing procrastination, such as simplifying tasks or providing default appointment, could improve engagement in critical health preventive behaviours.

General procrastination and bedtime procrastination as serial mediators of the relationship between temporal perspective and sleep outcomes

Adequate and sufficient sleep is essential for good health, effective functioning, and well-being, yet recent trends show increasing sleep deprivation, especially among adolescents and young adults. General procrastination and bedtime procrastination understood as the tendency to delay going to bed without external pressure, may contribute to sleep deprivation and fatigue. This study investigated how individual differences in time perspective are related to sleep sufficiency and daytime fatigue, two different sleep outcomes. For these relationships, the possible role of an intermediate pathway leading through general procrastination and then through bedtime procrastination was also examined. Zimbardo Time Perspective Inventory, Irrational Procrastination Scale, Bedtime Procrastination Scale, and Sleep Inventory were completed online by 399 university students (89% females) between the ages of 19 and 27 (M = 21.7, SD = 1.83). Future time perspective predicted lower general procrastination, which in turn was associated with lower bedtime procrastination, and consequently higher sleep sufficiency and lower daytime fatigue. Past negative time perspective predicted higher general procrastination, which in turn was associated with higher bedtime procrastination and consequently lower sleep sufficiency and higher daytime fatigue. These findings suggest that time perspective, general procrastination and bedtime procrastination may play an important role in predicting sleep sufficiency and daytime fatigue.

Factorial validation and invariance of the Academic Procrastination Scale in Colombian students

BACKGROUND

Academic procrastination is an increasingly pertinent issue among university students, impacting their academic performance, interpersonal relationships, and emotional well-being. However, brief assessment tools for timely intervention are scarce, especially in the Colombian context. Therefore, this study aims to evaluate the psychometric properties of the academic procrastination scale and analyze its relationship with mental health and life satisfaction.

METHODS

A total of 805 Colombian university students were selected through convenience sampling. Their ages ranged from 17 to 35 years, with an average age of 20.4 years (SD = 3.0).  RESULTS: The findings reveal a modified two-factor structure of the scale, with adequate fit indices (χ2 = 65.65, df = 13, p < .001; CFI = .96, TLI = .93, RMSEA = .07 (90% CI .06 - .09), SRMR = .03) and loadings above .50. Furthermore, both factors of the scale exhibited high reliability, with Cronbach's alpha and McDonald's omega coefficients greater than .80. The scale was also found to be gender invariant. Lastly, academic procrastination correlates positively with mental health and negatively with life satisfaction, while mental health relates negatively to life satisfaction.

CONCLUSION

The Modified Academic Procrastination Scale (EPA-C) demonstrates adequate psychometric properties and is gender-invariant for assessing academic procrastination among Colombian university students. Moreover, it has an impact on the mental health and life satisfaction of these students.

Trajectories of procrastination among Swedish University students over one academic year: a cohort study

BACKGROUND

Procrastination is common among university students and associated with adverse outcomes such as physical and mental health problems. According to the Temporal motivation theory procrastination may vary over time depending on the temporal proximity to goals and deadlines.

AIMS

To determine if mean procrastination levels among university students varies over an academic year, and if trajectories of procrastination are moderated by gender identity, perfectionistic strivings, and/or perfectionistic concerns.

SAMPLE

Swedish university students (n = 1410).

METHODS

The cohort was followed with web-surveys at four time-points over one academic year (Late semester, Mid semester, After semester, and Early semester). Generalized Estimating Equations were used to estimate mean levels of self-rated procrastination at the different time-points.

RESULTS

We found only small fluctuations in mean procrastination levels over the academic year. Participants with high perfectionistic concerns demonstrated higher mean procrastination levels at all time-points, but neither gender identity, perfectionistic concerns nor perfectionistic strivings affected the slope of the mean procrastination trajectories.

CONCLUSIONS

In this cohort of Swedish university students, self-rated procrastination levels were stable over the academic year. Perfectionistic concerns, but not gender identity or perfectionistic strivings, was associated with higher levels of procrastination.

Mindfulness matters: Unveiling the relationship between trait mindfulness and procrastination - A three level meta-analysis

Procrastination is a personality tendency with several deleterious consequences. Trait mindfulness has been found to be associated with procrastination. Nevertheless, the relationship between trait mindfulness and procrastination has yielded inconsistent results in previous studies. Therefore, by utilizing a three-level random-effects meta-analysic model, the present study synthesized previous studies to investigate the relationship between trait mindfulness and procrastination and explore the potential moderators that may affect this relationship. A significant and negative relationship between trait mindfulness and procrastination (r = -0.365; p < 0.0001) was found by analyzing 36 effect sizes from 19 studies with 14,094 participants. The subsequent moderator analysis did not reveal any significant moderators. Overall, the current meta-analysis shed insightful light on information for future research on reducing procrastination by considering utilizing mindfulness-based interventions that make it easier for individuals to maintain a mindfulness state and enhance trait mindfulness, thereby reducing procrastination.

The correlation between social adaptability and academic procrastination of undergraduate nursing students: the mediating role of resilience

BACKGROUND

How to mobilize nurses students' learning initiative, reduce the incidence of academic procrastination, and improve their social adaptability is a key factor in lowering nursing brain drain and improving nursing quality.

OBJECTIVE

To explore the mediating role of resilience in the correlation between social adaptability and academic procrastination of undergraduate nursing students.

METHODS

This study is a cross-sectional survey. The researchers conducted an electronic questionnaire survey of 962 nursing undergraduates in Guanzhong District, Shaanxi Province from November 2022 to April 2023, and adopted the intention sampling method. And make the following assumptions: (1) There is a significant negative correlation between academic procrastination and social adaptability. (2) Academic procrastination can directly affect the social adaptability of undergraduate nursing students, and it has a significant negative predictive effect. (3) Resilience can directly affect academic procrastination and social adaptability. At the same time, resilience plays an intermediary role between the two. In this study, the Aitken procrastination scale, the resilience scale, and the social adaptability diagnostic scale were used to evaluate undergraduate nursing students. SPSS27.0 software is used to analyze the data statistically, and the Hayes PROCESS Macro method is used to test the model.

RESULTS

The study's findings are as follows: 1) Academic procrastination significantly and negatively impacts social adaptability (c = -0.292, t = -6.407, p < 0.001). 2) Even when accounting for resilience, academic procrastination still significantly predicts lower social adaptability (c'= -0.204, t = -4.338, p < 0.001). 3) The Bootstrap method test of percentile bias correction indicates that resilience serves as a significant mediator between academic procrastination and social adaptability. Bootstrap SE = 0.018, 95% CI = (-0.124, -0.055). The indirect effect contributes to 29.79% of the total effect.

CONCLUSION

Resilience not only directly affects the academic procrastination and social adaptability of nursing students, but also partially intermediate the relationship between academic procrastination and social adaptability.

Procrastination, depressive symptomatology, and loneliness in later life

OBJECTIVES

Procrastination is an almost universal behaviour and yet little research to date has focused on procrastination among older adults. The purpose of this study was to explore the potential association between age and procrastination, and the potential mediating roles of depressive symptomatology and loneliness.

METHOD

Structural equation modelling was applied to data from 1309 participants (aged 29-92) from two waves United States Health and Retirement Study (2016-2020). Within the model, sex, education, marital status, and job status were added as covariates.

RESULTS

There was no statistically significant direct effect between age and procrastination (β = 0.06, p = 0.106). However, an indirect effect was present via depressive symptomatology (β = -0.40, p < 0.001). No mediating effect of loneliness was observed (β = - 0.01, p = 0.371). Subsequent analysis revealed that the symptoms, fatigue, loneliness, and lack of motivation significantly predicted procrastination.

CONCLUSION

While age was not directly associated with procrastination, increasing age was associated with a decreased likelihood of depressive symptomatology, which was in turn associated with an increased likelihood of procrastination. Such findings indicates that age demonstrates no association with procrastination because of the suppressing effect of depressive symptomatology.

Procrastination and risky health behaviors: a possible way to nurture health promotion among young adults in Italy

Background

The study's main objectives were to evaluate the distribution of levels of procrastination and its relationship with sleep quality, smoking status, alcohol consumption, and skipping breakfast, as a proxy measure of an unhealthy dietary pattern, among Italian university students.

Methods

A cross-sectional study was conducted at the "Magna Græcia" University of Catanzaro in the Southern part of Italy, using stratified random sampling techniques. Eligible students were sent an anonymous online survey aimed at assessing sociodemographic characteristics, procrastination levels using the Pure Procrastination Scale, sleep quality using Pittsburgh Sleep Quality Index, smoking status, alcohol consumption using WHO's Alcohol Use Disorders Identification Tool, and breakfast habits.

Results

The study included 518 participants with a mean age of 23 year. More than half of the sample was enrolled in medicine or life science majors and the procrastination mean score was 15 (±5.9 SD). Being procrastinators was significantly more frequently among students who were poor sleepers, hazardous alcohol consumers and breakfast skippers. When analyzing the clustering of risky behaviors, it was found that as the number of risky behaviors increased, the procrastination score exhibited an exponential increase.

Conclusion

The study findings showed that university students who engage in procrastination tend to adopt risky health behaviors. The data gathered could be useful to derive targeted interventions aimed at groups more exposed to harmful health behaviors and to encourage institutional policies to promote healthy lifestyles within universities. Universities can act as hubs for cultivating a culture of well-being and promoting a healthy environment.

Threats of nursing productivity in the digital era: investigating the interplay between smartphones addiction and procrastination behavior among nurses

BACKGROUND

Controlling smartphone addiction and procrastination among nurses is crucial for enhancing the productivity of both nursing and the healthcare system. Critical care nurses are highly vulnerable to smartphone addiction and procrastination behaviors than other groups. They may purposefully delay their tasks, a practice known as active procrastination, or inadvertently delay them, a practice known as passive procrastination.

AIM

This study was designed to assess the prevalence of smartphone addiction and procrastination behavior among nurses, examine the effect of smartphone addiction on the active and passive procrastination behaviors, and explore the correlation between active and passive procrastination behaviors among nurses.

METHOD

This is a descriptive correlational exploratory study that was conducted at 23 critical care units of one large educational hospital in Egypt. Data were collected from 360 nurses who were conveniently selected using three tools: the Smartphone Addiction Inventory, the New Active Procrastination Scale, and the Unintentional Procrastination Scale. Correlation and regression analyses were conducted to test the hypothetical relationship among the study variables.

RESULTS

This study revealed that 55.0%, 80.0%, and 45.3% of nurses had a moderate perceived level of smartphone addiction, active procrastination behavior, and passive procrastination behavior, respectively. There is a significant positive correlation between smartphone addiction and both nurses' active and passive procrastination behaviors. Smartphone addiction accounts for 25% of the variance in nurses' active procrastination behavior and 18% of the variance in their passive procrastination. Furthermore, there is a moderately significant negative correlation between nurses' active procrastination behavior and their passive procrastination behavior.

CONCLUSION

Nurses are exhibiting moderate levels of smartphone addiction and procrastination, which is a significant threat to the healthcare industry and nursing productivity. This requires technological, educational, and organizational interventions that foster active procrastination and combat passive procrastination behaviors among nurses.

IMPLICATIONS

Continuous training programs are required to enhance time management skills among nurses and increase the awareness of nurse managers with the symptoms of smartphone addiction among nurses. Nurse leaders should early detect and address the addictive use of smartphones among nurses, identify potential procrastinators, and provide counseling to eradicate these behaviors in the workplace.

Assessment of eating disorder symptoms, compulsive exercise, body dissatisfaction and depression in Swedish national team gymnasts, with a one-year follow-up

PURPOSE

The purpose of this study was to explore changes in symptoms of eating disorders, compulsive exercise, and depression, between two assessments 12 months apart, among elite gymnasts.

METHOD

Factors related to the development of mental health symptoms in male and female Swedish national team gymnasts were investigated using baseline and 1-year follow-up scores in two subscales of the Eating Disorders Inventory 3; drive for thinness and body dissatisfaction, two subscales of the Compulsive Exercise Test; avoidance and rule-driven behavior and exercise for weight control, and the Montgomery-Åsberg Depression Rating Scale-Self report (MADRS-S). Linear mixed models were used to investigate the influence of drive for thinness, exercise for weight control, avoidance and rule-driven behavior, and MADRS-S on body dissatisfaction.

RESULTS

Body dissatisfaction increased from baseline to the follow-up assessment, while drive for thinness and depression remained stable. Symptoms of eating disorders and depression were generally low in this group of elite gymnasts at both assessments. Drive for thinness, exercise for weight control, and symptoms of depression were associated with body dissatisfaction.

DISCUSSION

Our findings indicate that there were no significant changes over time in eating disorders and depression symptoms but significant associations with body dissatisfaction. Furthermore, we found independent effects of drive for thinness, exercise for weight control and symptoms of depression for body dissatisfaction.

Procrastination and Health in Nurses: Investigating the Roles of Stress, Health Behaviours and Social Support

Objectives: Evidence linking chronic procrastination to a range of poor health outcomes and trajectories continues to build. Yet, much of this research has been conducted in academic contexts or in non-student samples. Despite theory indicating that high-stress contexts increase vulnerability for procrastination, the pathways linking chronic procrastination to health outcomes proposed by the procrastination-health model have not been examined in a high stress environment. Accordingly, we tested the contribution of procrastination to health in nurses and whether social support was a protective factor. Design: Pre-registered cross-sectional study using a random sample of nurses recruited from the membership of a regional nursing association, supplemented by nurses and nurse trainees recruited from online nursing associations, conferences and forums. Methods: Nurses and nurse trainees (N = 597) completed measures of chronic procrastination, stress, health behaviours, social support and self-rated health. Results: Chronic procrastination was associated with perceived stress, health behaviours, self-rated health and social support in the expected directions. Consistent with the procrastination-health model, structural equation modelling revealed significant indirect effects linking chronic procrastination to poor self-rated health through higher stress and fewer health behaviours. Contrary to our hypotheses, social support did not moderate these pathways. Conclusions: This study is the first to demonstrate the relevance of procrastination for health in high-stress, non-academic contexts and to find support for both the stress and behavioural pathways linking procrastination to poor health outcomes. Findings further highlight the importance of addressing chronic procrastination as a vulnerability factor for poor health in nurses.

Unraveling symptom interplay: a network analysis of procrastination in gifted students

BACKGROUND

This study explores the intricate web of symptoms experienced by academically gifted high school students, focusing on procrastination, rumination, perfectionism, and cognitive flexibility. The well-being of these gifted adolescents remains a pivotal concern, and understanding the dynamics of these symptoms is vital.

METHODS

A diverse sample of 207 academically gifted high school students from Mashhad, Iran, participated in this study. Using convenience sampling, participants from grades 10, 11, and 12 were included, with detailed assessments conducted through questionnaires measuring the mentioned symptoms.

RESULTS

Our network analysis uncovers compelling insights into the interplay of these symptoms: Procrastination, though moderately central, exerts significant influence within the network, underscoring its relevance. Cognitive flexibility, while centrally positioned, curiously exhibits a negative influence, potentially serving as a protective factor. Negative perfectionism emerges as the keystone symptom, with both high centrality and a positive influence. Rumination displays substantial centrality and a positive influence, indicating its role in symptom exacerbation. Positive perfectionism, moderately central, lacks direct influence on other symptoms.

CONCLUSION

This network analysis provides a nuanced understanding of the relationships among procrastination, rumination, perfectionism, and cognitive flexibility in academically gifted adolescents. Negative perfectionism and cognitive flexibility emerge as critical factors deserving attention in interventions aimed at enhancing the well-being of this unique group. Further research should explore causal relationships to refine targeted interventions.

Effects of a single session low-threshold digital intervention for procrastination behaviors among university students (Focus): Findings from a randomized controlled trial

Introduction

Procrastination behaviors are common among university students, and have been found to be associated with stress, symptoms of depression, anxiety, and poorer academic performance. There is a need for interventions that can reach students at scale, and therefore this study aimed to estimate the effects of a single session low-threshold digital intervention (Focus) for procrastination behaviors among university students in Sweden.

Methods and analysis

A two-arm, parallel groups (1:1), single blind randomized controlled trial was conducted between February 8 to April 26, 2023. The study used email to invite university students across Sweden to participate in the trial. Both the intervention and the control group were invited to assess their current procrastination behaviors using the Pure Procrastination Scale (PPS). The intervention group immediately received feedback and behavior change advice by means of an interactive website, while the control group was shown their total PPS score without any further feedback. Students were included in the study if they scored 20 points or more on the PPS. Our primary outcome was procrastination behavior measured at 2 months post-randomization. Analyses were conducted using multilevel regression models estimated with Bayesian inference.

Results

A total of 2209 participants (intervention: 1109, control: 1100) were randomized. The average age of participants was 26.4 years (SD = 7.8) and 65 % were women (n = 1442). The mean PPS score at baseline was 35.6 points (of a maximum of 60). Primary outcome data were available for 45 % (n = 498) of the intervention group and 55 % (n = 601) of the control group. The evidence suggested no marked difference between groups regarding any of the outcomes, although there was weak evidence of lower physical activity in the intervention group. Qualitative findings from open-ended responses uncovered a variety of views on procrastination and perceived problems that may follow. Those not feeling supported by Focus explained having troubles adopting the advice given and converting their intentions into action without more continuous support.

Conclusions

Access to a single session of feedback and behavior change advice by means of an interactive website did not produce differential self-reported procrastination among university students who took the opportunity to self-assess their behaviors. The findings are limited by assessment reactivity due to screening at baseline and attrition to follow-up.

Procrastination, depression and anxiety symptoms in university students: a three-wave longitudinal study on the mediating role of perceived stress

BACKGROUND

It is generally assumed that procrastination leads to negative consequences. However, evidence for negative consequences of procrastination is still limited and it is also unclear by which mechanisms they are mediated. Therefore, the aim of our study was to examine the harmful consequences of procrastination on students' stress and mental health. We selected the procrastination-health model as our theoretical foundation and tried to evaluate the model's assumption that trait procrastination leads to (chronic) disease via (chronic) stress in a temporal perspective. We chose depression and anxiety symptoms as indicators for (chronic) disease and hypothesized that procrastination leads to perceived stress over time, that perceived stress leads to depression and anxiety symptoms over time, and that procrastination leads to depression and anxiety symptoms over time, mediated by perceived stress.

METHODS

To examine these relationships properly, we collected longitudinal data from 392 university students at three occasions over a one-year period and analyzed the data using autoregressive time-lagged panel models.

RESULTS

Procrastination did lead to depression and anxiety symptoms over time. However, perceived stress was not a mediator of this effect. Procrastination did not lead to perceived stress over time, nor did perceived stress lead to depression and anxiety symptoms over time.

CONCLUSIONS

We could not confirm that trait procrastination leads to (chronic) disease via (chronic) stress, as assumed in the procrastination-health model. Nonetheless, our study demonstrated that procrastination can have a detrimental effect on mental health. Further health outcomes and possible mediators should be explored in future studies.

The Interplay of Sleep Quality, Mental Health, and Sociodemographic and Clinical Factors among Italian College Freshmen

Background/Objectives: Sleep and mental health are closely linked, with sleep deprivation increasing the risk of mental health problems in college students. This study aimed to analyze the role of sleep in the mental health status of a sample of Italian freshmen, considering various mental health outcomes and potential interactions between sleep and other relevant factors, such as sociodemographic characteristics, academic experiences, and mental health history. Methods: All freshmen from a medium-sized Italian university were invited to participate in a multidimensional online survey (n = 3756). Sleep quality was assessed through questions on average hours of sleep per night and on satisfaction of perceived sleep quality. Mental health outcomes included psychophysical well-being, psychological distress, substance use, and problematic internet use. Statistical analysis involved multivariate analysis of variance, followed by pairwise comparisons. Results: The sample (n = 721) exhibited low levels of well-being and a high prevalence of psychological distress (52.1%). Approximately one-third of students (n = 258) were dissatisfied with their sleep quality, and one-fourth (n = 186) reported inadequate sleep (less than 7 h per night). More specifically, 24.4% of students slept on average six hours per night, and 1.4% slept five hours or less. Satisfaction with perceived sleep quality significantly influenced well-being, psychological distress, and cannabis use (ηp2 = 0.02). Interaction effects were observed between satisfaction with sleep quality and drop-out intentions (ηp2 = 0.01), as well as between satisfaction with sleep quality and history of mental health diagnosis (ηp2 = 0.02), both of which were significant for psychological distress and cannabis use. Conclusions: This study highlights the influence of perceived sleep quality on academic distress among college freshmen, particularly those with higher intentions of leaving university and with a history of mental health diagnosis.

Associations of recent stressful life events with anxiety symptoms among Chinese adolescents with a consideration of family functioning

Background: The association between stressful life events (SLEs) and adolescent anxiety symptoms has been extensively studied, but the specific impacts of different SLEs domains remain inconclusive. Moreover, limited research has examined the role of family functioning in these associations.Objective: This study aimed to investigate the associations between various recent SLEs and adolescent anxiety symptoms and explore the role of family functioning.Methods: Data were obtained from the second phase of the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research in Guangzhou, China. A total of 10,985 students (51.9% boys; mean [SD] age, 15.3 [1.5] years) from forty middle schools participated in the study in 2022 and completed a self-report questionnaire assessing anxiety symptoms, SLEs, and family functioning using the Generalized Anxiety Disorder-7 (GAD-7), Adolescent Self-rating Life Events Checklist (ASLEC; including five subscales: interpersonal stress, academic stress, punishment-related stress, loss-related stress, and adaptation-related stress), and the adapted Chinese version of the Family Assessment Device (FAD), respectively. Linear mixed-effects models were performed and the moderation role of family functioning was also examined.Results: The fully adjusted model revealed that a 1-SD increase in the overall ASLEC score was associated with higher levels of anxiety symptoms (β = 2.23, 95%CI: 2.15-2.32). Among various SLEs domains, the academic domain shows the most significant association (β = 2.25, 95%CI: 2.17-2.33). Family functioning exerted an independent protective influence on anxiety symptoms, with each 1-SD increase in FAD scores negatively associated with anxiety symptoms (β = -2.11, 95%CI: - 2.29 to - 1.93) in the adjusted model. Moreover, family functioning significantly buffered the impacts of overall SLEs and each domain, except for adaptation-related SLEs, on anxiety symptoms.Conclusion: Higher recent SLEs levels were associated with increased anxiety symptoms among adolescents, with academic SLEs showing the greatest association. Positive family functioning had both direct and buffering influences on anxiety symptoms.

The top 100 highly cited articles on neck pain: A bibliometric analysis

Objective

Neck pain has emerged as a significant public health concern. This study is to unveil the present state of neck pain research, thereby furnishing invaluable insights for prospective research endeavours and clinical applications.

Methods

The study was initiated by searching the Web of Science Core Collection database, focusing on "neck pain". From the amassed results, the top 100 most cited references were imported into CiteSpace and VOSviewer, enabling a rigorous bibliometric analysis. To ensure precision, synonymous terms conveying similar meanings were harmonized. The bibliometric study encompassed countries, research institutions, authors, journals, and keyword analysis.

Results

The investigation centered on a curated compilation of 100 articles, disseminated across a diverse array of 36 scholarly journals. These seminal articles originated from 24 distinct countries, reflecting contributions from a wide spectrum of 188 research institutions. Impressively, a collaborative effort involving 385 authors emerged. Noteworthy core research countries included the United States and Australia, with the University of Queensland and the University of Toronto asserting notable influence. Prolific authors such as J. David Cassidy and Pierre Cote garnered attention. Present research endeavours pivot around the incidence of neck pain, the identification of risk factors, the efficacy evaluation of treatment modalities, and a pronounced focus on high-quality randomized controlled trials and systematic reviews.

Conclusion

The study shines a light on key research countries, influential institutions, prominent authors, and prevalent trends, effectively contributing to comprehending the knowledge landscape and research dynamics in the field of neck pain.

Emotional dysregulation predicts problematic gaming in children and youths: a cross-sectional and longitudinal approach

Adolescents show a high vulnerability for addictive gaming patterns on the one hand and immature emotion regulation (ER) abilities as a risk factor for mental disorders on the other hand. We investigated the predictive value of ER difficulties on problematic gaming (PG) considering age groups (children vs. youths) and gender cross-sectionally and prospectively in a representative sample of German adolescents via online survey with two measurement points 14 months apart. General Poisson, logistic, and multinomial regression models were estimated to predict gaming patterns by ER difficulties controlling for age group and gender. Results revealed ER difficulties to be significantly associated with PG. Moreover, subgroup analyses indicated differing ER patterns for children vs. youths and boys vs. girls: for children, higher PG values were associated with emotional awareness and emotional clarity whereas for youths it was the acceptance of emotional responses. Moreover, gender differences implicated that boys with PG had more deficits in goal-oriented behavior as well as emotional awareness while affected girls were lacking emotional clarity and had problems with the acceptance of their emotional responses. Interestingly, procrastination was a significant predictor for PG irrespective of subgroups. Furthermore, longitudinal analyses indicated that difficulties in ER promoted PG while stronger procrastination tendencies maintained it. With the inclusion of procrastination, which can be understood as a maladaptive ER strategy, a broader picture of ER difficulties as a risk factor for PG could be drawn. The findings support a better understanding of PG etiology and the development of targeted prevention and intervention measures.

The correlation between mobile phone addiction and procrastination in students: A meta-analysis

BACKGROUND

Mobile phone addiction (MPA) has been extensively researched as an important factor for students' procrastination. However, the direction and magnitudes of the correlation between MPA and procrastination remain unclear. This meta-analysis, thus, aims to explore the relationship between MPA and procrastination in students, as well as the moderating effects of participant's individual characteristics (education level and sex), measurement tools, and social situational factors (publication year and culture).

METHODS

Qualified studies were obtained through a systematic search of PubMed, Web of Science, Embase, PsycINFO, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu. Meta-analysis was conducted in the CMA 3.0 software, and meta-analysis of variance (ANOVA) was used to test the moderating effect.

RESULTS

A total of 75 studies, including 48,031 participants, were obtained. The combined effect size of the random effects model showed a significant positive correlation between MPA and procrastination in students (r = 0.376, 95 % CI [0.345, 0.406]). Education level, sex, culture, and MPA measurement tools significantly moderated the correlation between MPA and procrastination. However, the correlation was not moderated by the year of publication and the measurement tools of procrastination.

CONCLUSION

MPA is positively correlated with procrastination in students. Given the high incidence of MPA in students and its potential risk factors for procrastination, attention should be paid to the identification and intervention of MPA to prevent students from procrastination.

Association between physical activity and depressive symptoms in adolescents: A prospective cohort study

It remains uncertain whether a protective association between physical activity and depression exists among adolescents and what the optimal level of physical activity might be. This study aimed to estimate the associations of physical activity levels with depressive symptoms and new-onset depression, while identifying potential modifying factors influencing the relationships. In this cohort study, we initially enrolled 1957 participants at baseline and followed up with 1738 of them after two years. Our analysis focused on data from 1482 students who provided complete information on both physical activity and depressive symptoms. Generalized linear regression and restricted cubic spline regression models were performed. Our adjusted models revealed that engaging in 4-7 h/week of moderate-to-vigorous physical activity (MVPA) at baseline was negatively associated with subsequent depressive symptoms and new-onset depression compared to the non-MVPA group. However, exceeding 7 h/week of MVPA did not provide substantial benefits. Furthermore, drinking and screen time potentially modified the relationship between MVPA and new-onset depression. Our findings suggest that 4-7 h of MVPA per week may be an appropriate level to reduce depressive symptoms in adolescents. Moreover, individual behaviors (e.g., drinking and screen time) warrant heightened attention in interventions targeting the reduction of depression in this population.

The association between perfectionism and academic procrastination among undergraduate nursing students: The role of self-efficacy and resilience

AIMS

This study aimed to investigate the associations between perfectionism and undergraduate nursing students' academic procrastination, the mediating effects of self-efficacy and the moderating role of resilience.

DESIGN

A cross-sectional survey.

METHODS

The survey was conducted from March to May 2022 with a sample of 587 undergraduate nursing students in two undergraduate universities in China. A descriptive statistical approach, Pearson's correlation analysis and the Hayes' PROCESS Macro model 4 and 14 were used to analyse the available data.

RESULTS

Adaptive perfectionism and maladaptive perfectionism negatively and positively predicted academic procrastination in nursing undergraduates, respectively. Self-efficacy played a partially mediating role in the association between adaptive perfectionism and academic procrastination. Furthermore, resilience played a moderating role in the association between adaptive perfectionism and academic procrastination.

CONCLUSIONS

Maladaptive perfectionism and low levels of resilience and self-efficacy may increase the risk of academic procrastination among nursing undergraduates. Nursing educators can take measures to decrease the risk of academic procrastination among nursing undergraduate students by guiding them to cultivate adaptive perfectionism tendencies and improve their self-efficacy and resilience.

IMPACT

The findings of this study can be used to develop targeted coping and prevention measures for nursing educators to reduce the incidence of academic procrastination among nursing undergraduates.

PATIENT OR PUBLIC CONTRIBUTION

Five hundred eighty-seven undergraduate nursing students from two undergraduate universities participated in the study and responded to questions on perfectionism and academic procrastination, etc.

Procrastination and health: A longitudinal test of the roles of stress and health behaviours

OBJECTIVES

Procrastination is a common form of self-regulation failure that a growing evidence base suggests can confer risk for poor health outcomes, especially when it becomes habitual. However, the proposed linkages of chronic procrastination to health outcomes have not been tested over time or accounted for the contributions of higher-order personality factors linked to both chronic procrastination and health-related outcomes. We addressed these issues by examining the role of chronic procrastination in health outcomes over time in which the hypothesized links of procrastination to health problems operate via stress and health behaviours.

DESIGN

Three-wave longitudinal study with 1-month intervals.

METHODS

Participants (N = 379) completed measures of trait procrastination at Time 1, and measures of health behaviours, stress and health problems at each time point, in a lab setting.

RESULTS

Procrastination and the health variables were inter-related in the expected directions across the three assessments. Chronic procrastination was positively associated with stress and negatively with health behaviours at each time point. Path analysis testing a cross-lagged longitudinal mediation model found an indirect relationship operating between procrastination and health problems via stress, after accounting for the contributions of conscientiousness and neuroticism.

CONCLUSIONS

This research extends previous work by demonstrating that the links between chronic procrastination and poor health are accounted for mainly by higher stress, after accounting for other key traits, and that these associations are robust over time. The findings are discussed in terms of the importance of addressing habitual self-regulation failure for improving health.

Evaluating the effectiveness of a brief digital procrastination intervention targeting university students in Sweden: study protocol for the Focus randomised controlled trial

INTRODUCTION

The concept of procrastination can be described as a conscious, yet irrational, postponement of important tasks or decisions-despite awareness that the delay may lead to negative consequences. Procrastination behaviours are common among university students and is often described as a failure of self-regulation, and the behaviour is associated with stress, symptoms of depression and anxiety, poorer academic performance and negative effects on overall health and well-being.

METHODS AND ANALYSIS

A two-arm, parallel groups (1:1), single-blind randomised controlled trial will be conducted to assess the effectiveness of a brief digital procrastination intervention (Focus) among university students in Sweden. The intervention consists of a screening and feedback component based on Pure Procrastination Scale (PPS) score, allowing intervention participants to assess their current procrastination behaviours and receive behaviour change advice. Participants in the control group will be shown their total PPS score without any further feedback. Monte Carlo simulations (assuming a standardised effect of 0.35 Cohen's d of the intervention on the primary outcome, to at least 80% of the time estimate a posterior probability of effect of at least 95%) indicated that data from 1000 participants are required for analysis, meaning that 2000 participants are required to be randomised when assuming a 50% attrition rate. The primary outcome will be procrastination behaviour measured at 2 months postrandomisation. Secondary outcomes will be anxiety and stress symptoms and lifestyle behaviours. Outcomes will be analysed using multilevel regression models estimated using Bayesian inference.

ETHICS AND DISSEMINATION

The study was approved by the Swedish Ethical Review Authority on 2022-08-24 (dnr 2022-00353). Students will be asked to give informed consent before participation and after having been given information about the study. The results will be submitted for publication in open access, peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ISRCTN13533793.

Procrastination and Stress: A Conceptual Review of Why Context Matters

Research over the past two decades has continued to highlight the robust associations between procrastination and stress across multiple populations and contexts. Despite this burgeoning evidence base and theory linking procrastination to higher levels of stress, as well as the reverse, the role of context in this potentially dynamic association has received relatively little attention. In this conceptual review I argue that from a mood regulation perspective of procrastination, stressful contexts necessarily increase risk for procrastination because they deplete coping resources and lower the threshold for tolerating negative emotions. Drawing on insights from coping and emotion regulation theory, the new stress context vulnerability model of procrastination proposes that the risk for procrastination increases in stressful contexts primarily because procrastination is a low-resource means of avoiding aversive and difficult task-related emotions. The new model is then applied to evidence on the primary and secondary sources of stress during the COVID-19 pandemic and how they may have increased vulnerability for procrastination. After discussing potential applications of the new model for understanding how and why risk for procrastination may increase in other stressful contexts, approaches that might mitigate vulnerability for procrastination in high-stress contexts are discussed. Overall, this new stress context vulnerability model underscores the need for taking a more compassionate view of the antecedents and factors that may increase the risk for procrastination.