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Guo Z, Li Y, Wang L, Lin X, Sun J, Yu J, Mao L, Zhu X, Miao Y, Li C. Mental Health Concerns in Patients with COVID-19: A Network Analysis. Psychol Res Behav Manag 2025; 18:1125-1137. [PMID: 40406339 PMCID: PMC12095440 DOI: 10.2147/prbm.s524256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2025] [Accepted: 04/26/2025] [Indexed: 05/24/2025] Open
Abstract
Purpose Patients with coronavirus disease 2019 (COVID-19) are predisposed to associated mental health problems, including intolerance of uncertainty (IUS), perceived stress (PSS), low sense of control, dysfunctional beliefs and attitudes about sleep (DBAS), insomnia, and impaired feeling of security. However, these mental health concerns have not been studied in a joint framework. This study aimed to investigate the relationships and putative causality among the aforementioned six variables and determine relatively important ones, indicating potential intervention strategies for the associated mental health concerns. Patients and Methods A total of 1015 inpatients with COVID-19 aged 18 years or older in the Shanghai shelter hospital completed validated self-report scales to assess relevant psychopathological constructs. Two network models, a Graphical Gaussian Model (GGM) and a Directed Acyclic Graph (DAG), were estimated based on collected cross-sectional data. Results The GGM network was reliably stable, highlighting five strongest associations such as the connection between IUS "Intolerance of uncertainty" and DBAS "Dysfunctional beliefs and attitudes about sleep". IUS was identified as the most central node. The DAG network suggested the key triggering role of PSS "Perceived stress" for other downstream variables. Conclusion This study provided insights into the complex pairwise connections between the mental health concerns and the pivotal roles of intolerance of uncertainty and perceived stress. The study findings were discussed in terms of both theoretical and clinical implications that might serve for the intervention of psychological distress and promotion of mental health in patients with COVID-19 or similar epidemics.
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Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Yijun Li
- Department of Military Medical Psychology, The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Lingling Wang
- Department of Military Medical Psychology, The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Xinxin Lin
- Department of Military Medical Psychology, The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Jingjing Sun
- No.10 Outpatient Department of Internal Medicine, 986 hospital of The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Jing Yu
- Department of Radiology, 986 hospital of The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Li Mao
- Department of Radiology, 986 hospital of The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Xia Zhu
- Department of Military Medical Psychology, The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Ye Miao
- Department of Obstetrics and Gynaecology, Tangdu Hospital of The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Chenxi Li
- Department of Military Medical Psychology, The Fourth Military Medical University, Xi’an, People’s Republic of China
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Gou M, Li L, Wang X, Yuan P, Li S, Wei Y, Zhou G. Risk Perception and Maternal Prenatal Depressive Symptoms in the Early Stage of COVID-19 Pandemic in China: Role of Negative Emotions and Family Sense of Coherence. Matern Child Health J 2024; 28:1631-1640. [PMID: 38856799 DOI: 10.1007/s10995-024-03964-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Prenatal depression is associated with adverse health outcomes for both mothers and their children. The worldwide COVID-19 pandemic has presented new risks and challenges for expectant mothers. The aims of the study were to investigate the underlying mechanism between COVID-19 risk perception of Chinese pregnant women and their prenatal depressive symptoms and potential protective factors such as family sense of coherence (FSOC). METHOD A total of 181 Chinese pregnant women (Mage = 31.40 years, SD = 3.67, ranged from 23 to 43) participated in an online survey from April 22 to May 16, 2020. Risk perception and negative emotions (fear and anxiety) related with COVID-19, FSOC, and prenatal depressive symptoms were assessed. RESULTS The experience of maternal COVID-19 related negative emotion fully mediated the positive relationship between COVID-19 risk perception and prenatal depressive symptoms of pregnant women (β = 0.12, 95% CI [0.06, 0.19]). When confronting COVID-19 related fear and anxiety, expectant mothers from higher coherent families experienced a significantly lower level of prenatal depressive symptoms. CONCLUSIONS Contextual negative emotional experience was demonstrated to explain how risk perception impacts depressive symptoms during severe public health crisis for pregnant women. FSOC may be a psychological resource protecting pregnant women from experiencing adverse psychological outcomes during COVID-19 pandemic.
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Affiliation(s)
- Mengke Gou
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, 100871, China
| | - Luyao Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 Hua yuan north Road, Hai Dian district, Beijing, China
| | - Xi Wang
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, 100871, China
| | - Pengbo Yuan
- Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 Hua yuan north Road, Hai Dian district, Beijing, China
| | - Shuang Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 Hua yuan north Road, Hai Dian district, Beijing, China
| | - Yuan Wei
- Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 Hua yuan north Road, Hai Dian district, Beijing, China.
| | - Guangyu Zhou
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, 100871, China.
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Huang J, Yang Z, Wang Q, Liu J, Xie W, Sun Y. The relationship between family cohesion and bedtime procrastination among Chinese college students: the chain mediating effect of coping styles and mobile phone addiction. BMC Psychiatry 2024; 24:250. [PMID: 38566050 PMCID: PMC10988965 DOI: 10.1186/s12888-024-05700-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Bedtime procrastination refers to an individual's inability to go to bed at a predetermined time without external obstacles. Previous researchers have found that the bedtime procrastination is harmful to human physical and mental health, but these research on bedtime procrastination have mostly focused on exploring individual factors, while ignoring the external environmental factors. Therefore, this is the first study to investigate bedtime procrastination from the perspective of family environments. METHODS The study was conducted using a convenient sampling method and online questionnaires. Family Cohesion Scale, Coping Styles Questionnaire, Mobile Phone Addiction Tendency Scale and Bedtime Procrastination Scale were used to measure sleep and psychological condition of 1,048 college students. RESULTS Family cohesion negatively predicted bedtime procrastination. Additionally, positive coping style and mobile phone addiction had significant independent mediating effects. Furthermore, positive coping style and mobile phone addiction had chain mediating effects between family cohesion and bedtime procrastination. CONCLUSION This study revealed the effect of coping styles and mobile phone addiction on the relationship between family cohesion and bedtime procrastination among Chinese college students. These findings explained the mechanisms of bedtime procrastination from the perspective of environment, so as to effectively intervene the bedtime procrastination of college students from the perspective of external environment.
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Affiliation(s)
- Jiahao Huang
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, 325035, Wenzhou, China
- Faculty of Psychology, Tianjin Normal University, 300387, Tianjin, China
| | - Zhenliang Yang
- Faculty of Psychology, Tianjin Normal University, 300387, Tianjin, China
| | - Qian Wang
- Faculty of Psychology, Tianjin Normal University, 300387, Tianjin, China
| | - Junling Liu
- Faculty of Psychology, Tianjin Normal University, 300387, Tianjin, China
| | - Wenlan Xie
- Children's Research Institute, Ningbo Childhood Education College, 315000, Ningbo, China.
| | - Yuqi Sun
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, 325035, Wenzhou, China.
- Zhejiang Haozhonghao Health Products Co., Ltd, 325409, Wenzhou, China.
- Zhejiang Jerinte Health Technology Co., Ltd, 310013, Hangzhou, China.
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Hassan-Abbas NM. Daily stress, family functioning and mental health among Palestinian couples in Israel during COVID-19: A moderated mediation model. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2023; 40:1770-1791. [PMID: 38603143 PMCID: PMC9637906 DOI: 10.1177/02654075221130785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The COVID-19 pandemic created a range of stressors, among them difficulties related to work conditions, financial changes, lack of childcare, and confinement or isolation due to social distancing. Among families and married individuals, these stressors were often expressed in additional daily hassles, with an influence on mental health. This study examined two moderated mediation models based on Bodenmann's systemic-transactional stress model. Specifically, the models tested the hypothesis that intra-dyadic stress mediates the association between extra-dyadic stress and mental health, while two measures of family functioning, cohesion and flexibility, moderate the relationship between extra and intra-dyadic stress. Participants were 480 Palestinian adults in Israel who completed self-report questionnaires. All were in opposite-sex marriages and identified as either cisgender women or cisgender men. The results showed partial mediation patterns supporting both models, indicating that family cohesion and flexibility weakened the mediating effect of intra-dyadic stress on the relationship between extra-dyadic stress and mental health. These findings increase our understanding of the variables that affected mental health during the pandemic, and suggest that when faced with extra-dyadic stress, married individuals with good family environments are less likely to experience high levels of intra-dyadic stress, which is in turn associated with preserved mental health. Limitations and implications for planning interventions for couples and families during the pandemic are discussed.
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Affiliation(s)
- Niveen M. Hassan-Abbas
- Department of Special Education and Psychology, Department of Behavioral Sciences, Zefat Academic College, Safed, Israel
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Zhu X, Gao M, Cheng X, Zhao W. Sleep - the guarantee of health! Does the environmental perception characteristics of urban residential areas affect residents' sleep quality? Front Public Health 2023; 10:1017790. [PMID: 36743169 PMCID: PMC9889991 DOI: 10.3389/fpubh.2022.1017790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023] Open
Abstract
A complex urban living environment and residents' sleep quality are intrinsically linked. Nonetheless, there is little evidence that the residential environment affects sleep quality. Based on the results of subjective questionnaires, this study uses the multiple regression combined with mediation analysis to construct a mechanical model of the impact of urban residential environmental perception characteristics on residents' sleep quality. Moreover, the differences among the influence intensities of the significant factors are compared and the results show that (1) in low-density environments (FAR < 2) and lower floors (4-6), residents sleep longer and have better sleep quality; (2) the environmental quality and service facilities of the physical environment and the sense of safety in the social environment have a significant impact on residents' sleep quality; and (3) the mental health of residents play a significant intermediary role in the relationship between social environment and sleep quality, with the highest effect accounting for 33.88%. The influence mechanisms of various environmental factors in a residential area on sleep quality were revealed and a more refined design basis for a healthy urban living environment, community renewal, and renovation was provided.
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Affiliation(s)
- Xun Zhu
- School of Architecture, Harbin Institute of Technology, Harbin, China
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, China
| | - Ming Gao
- School of Architecture, Harbin Institute of Technology, Harbin, China
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, China
| | - Xinting Cheng
- School of Architecture, Harbin Institute of Technology, Harbin, China
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, China
| | - Wei Zhao
- School of Architecture, Harbin Institute of Technology, Harbin, China
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, China
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Xian X, Zhang Y, Bai A, Zhai X, Hu H, Zhang J, Ye M. Association between Family Support, Stress, and Sleep Quality among College Students during the COVID-19 Online Learning Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:248. [PMID: 36612570 PMCID: PMC9819990 DOI: 10.3390/ijerph20010248] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/14/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: During the past 3 years, the COVID-19 pandemic has severely affected the normal school schedule of college students, jeopardizing their mental health, sleep quality, and interpersonal relationships. However, previous studies have focused on the dimension of social support received, and few studies have measured in depth the association of support received from family on adolescents’ physical and mental health. Therefore, this study explored the associations between family support received by Chinese college students during COVID-19 pandemic online classes, stress and sleep quality, and the mediating role of stress. (2) Methods: A cross-sectional study conducted at Chongqing Medical University recruited 712 college students through a university-wide incidental random sample using the Questionnaire Star platform. Statistical description and correlation analysis was conducted using SPSS 25.0, and structural equation modeling was constructed using AMOS 22.0 to test for mediating effects; (3) Results: The family support score of college students during the COVID-19 pandemic online course was 19.41 ± 4.62. Correlation analysis showed that sleep quality was negatively correlated with family support (r = −0.224, p < 0.01), positively correlated with stress (r = 0.324, p < 0.01), and family support was negatively correlated with stress (r = −0.159, p < 0.01). The results of structural equation modeling showed that stress partially mediated the relationship between family support and sleep quality among college students (indirect effect = −0.150, p < 0.01, SE = 0.013,95% CI = [−0.208, −0.064]). The model R2 was 36.4%. (4) Conclusions: Schools should consider implementing sleep education, and stress relief curriculum measures to improve the quality of students’ sleep, and should focus on the role that family plays during online classes. This will help students overcome the negative emotional effects of stress in the COVID-19 pandemic and improve their learning efficiency and physical and mental health.
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