Mental health prevalence and predictors among university students in nine countries during the COVID-19 pandemic: a cross-national study

Mindful Self-Hypnosis Combined with Resistance Training to Reduce Perceived Stress and Improve Other Psychological Factors in Female College Students

Perceived stress is a significant problem among female college students that can impact psychological distress, sleep, and overall well-being. Mindful self-hypnosis (MSH) and resistance training (RT) have both been shown to reduce perceived stress. The rationale for the present study was to investigate whether MSH combined with RT could be more effective at reducing perceived stress as measured by the Perceived Stress Scale than RT alone due to synergistic effects achieved by combining the interventions. Forty-four female college students were randomized to one of the three groups: MSH+RT, RT only, or a wait-list control (WLC). Results indicated that, compared to RT only, the addition of MSH led to pronounced improvements in perceived stress which was significantly greater than WLC. Also, MSH+RT resulted in significant increases in mindfulness, sleep, strength, and well-being in comparison to WLC. MSH+RT was shown to be feasible with highly satisfactory participant ratings. Future research should examine the MSH+RT intervention with a larger population and with older women who are more at risk for stress and declining strength.

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

Individuals' attitudes toward digital mental health apps and implications for adoption in Portugal: web-based survey

BACKGROUND

The literature is consensual regarding the academic community exhibiting higher levels of mental disorder prevalence than the general population. The potential of digital mental health apps for improving access to resources to cope with these issues is ample. However, studies have yet to be performed in Portugal on individuals' attitudes and perceptions toward digital mental health applications or their preferences and decision drivers on obtaining mental health care, self-assessment, or treatment.

OBJECTIVE

This study aims to understand the determinants of digital mental health applications use in the Portuguese academic community of Porto, along with potential adoption barriers and enablers.

METHODS

A cross-sectional, web-based survey was delivered via dynamic email to the University of Porto's academic community. Data collection occurred between September 20 and October 20, 2022. We used structural equation modeling to build three models, replicating a peer-reviewed and published study and producing a newly full mediation model shaped by the collected data. We tested the relationships between use of digital mental health apps and perceived stress, perceived need to seek help for mental health, perceived stigma, past use of mental health services, privacy concerns, and social influence.

RESULTS

Of the 539 participants, 169 (31.4%) reported having used digital mental health apps. Perceived stress and a latent variable, comprising perceptions of mental health problems and coping strategies, were positively associated with mental health app use, while privacy concerns regarding one's information being accessible to others were negatively associated. Perceived stigma, need to seek help, and close relationships did not have a statistically significant direct effect.

CONCLUSIONS

These findings can inform product and policy development of new, better-targeted digital mental health app interventions, with implications for researchers and academia, industry, and policymakers. Our study concludes that, to maximize adherence to these apps, they should have low to no financial charges, demonstrate evidence of their helpfulness and focus on the timely delivery of care. We also conclude that to foster digital mental health app use, there is a need to improve mental health literacy, namely regarding self-awareness of one's conditions, acceptable stress levels, and overall behavior towards mental health.

TRIAL REGISTRATION

RR2-10.2196/41040.

Study on the impact of COVID-19 pandemic on the mental health of Chinese college students: a cross-sectional analysis

Background

The COVID-19 pandemic has significantly impacted the mental health of college students, prompting the need for universities to implement measures to mitigate these adverse effects. This study aims to assess the mental health status and mitigation measures of college students, identify the primary factors contributing to their mental health challenges, and provide suggestions for educational institutions to reduce negative psychological impacts.

Methods

In February 2023, a questionnaire survey was conducted among 1,445 college students. Statistical analysis was performed on the survey results, and multiple regression models were used to identify significant influencing factors and optimize the model.

Results

The study revealed correlations between factors affecting mental health during the pandemic, with interactions observed among some factors. Significant differences in mental health status were found among different groups of college students based on their information-sharing habits through apps and engagement in thesis research. Multiple regression analysis indicated that conducting academic research related to COVID-19 significantly increased the psychological stress of college students during the pandemic (p = 0.043). Among all mitigation measures, playing games demonstrated significant effectiveness in model analysis (p = 0.047). The optimization of the model showed that the multiple regression model considering the interaction of factors was more effective.

Conclusion

Our research identifies crucial factors influencing the mental health of college students and investigates the mental health status of various student groups. We recommend that educational institutions adopt proactive strategies and a multifaceted approach to support the mental health of college students and address potential issues that may arise.

Sociocultural adjustment and social support as predictors for international medical sciences students' anxiety during COVID-19

BACKGROUND

The prevalence of anxiety is high among international medical sciences students and it increased even more during the COVID-19 pandemic due to different restrictions and social isolation. Successful sociocultural adjustment and social support could be important factors in overcoming those challenges, however, there is a lack of studies which would investigate the role of those factors among inter- national medical students. This study aimed to assess the role of sociocultural adjustment and social support as predictors for international medical students' anxiety during COVID-19.

METHODS

Two measurements were conducted via self-reported questionnaires which consisted of three scales - SCAS, MSPSS and GAD-7. In total, 82 international medical students participated in both measurements in this longitudinal study.

RESULTS

The findings indicated that 37% of international students had symptoms of moderate or severe anxiety during their first year of studies at university. In the second year, during the COVID-19 pandemic and an official lockdown, 35% of international students had symptoms of moderate or severe anxiety. In addition, this study showed that gender and sociocultural adjustment did not play a role as predictors of students' anxiety during the second year of studies. However, this study revealed that social support provided by family during the first year of studies, as well as having friends or family members who had been ill with COVID-19 predicted higher levels of anxiety at second measurement, while sociocultural adjustment was an even stronger predictor of anxiety in the second year of studies of international medical students.

CONCLUSIONS

This knowledge can help to better understand how international medical students felt during the COVID-19 pandemic and what role the above- mentioned factors played in the students' anxiety. As the anxiety level is quite high among international medical students, universities and mental health service providers should take it into consideration and help them to overcome those challenges.

Differences between Health and Non-Health Science Students in Lifestyle Habits, Perceived Stress and Psychological Well-Being: A Cross-Sectional Study

The aim of this study was to investigate lifestyle habits in health and non-health science students from the University of Split, Croatia, and to evaluate their association with perceived stress and psychological well-being. We surveyed 783 students during February-March 2021. Hierarchical multiple regression analysis was used in the analysis. Health science students spent less time using screens, were sitting less, slept less, but also showed better compliance with the Mediterranean diet compared to non-health science students (10.6% vs. 5.9%). There were no differences in stress and well-being perception between the two study groups. Female gender, lack of sleep, less daily sitting time, anxiety, and lower optimism were associated with higher stress in non-health science students, while anxiousness and more sitting were found to be significant among health students. Well-being among health science students was positively associated with BMI, having had COVID-19, being refreshed after waking up during working days, Mediterranean diet adherence, health perception, optimism, and quality of life, and negatively with TV time and anxiousness. Shorter sleep duration on non-working days, feeling refreshed after waking up on non-working days, higher quality of life and optimism, and lower anxiousness were associated with higher well-being among non-health students. Identifying unhealthy lifestyle habits in students is essential for implementing targeted interventions to better their health outcomes.

The varied restorative values of campus landscapes to students' well-being: evidence from a Chinese University

BACKGROUND

The literature on therapeutic landscapes highlights that the university campus landscape has restorative effects on students. This deserves more scholarly attention since mental health has become an important issue among university students. However, existing empirical studies have revealed mixed evidence with little attention to the heterogeneity across the design and, therefore, the potential therapeutic effects across different landscapes.

METHOD

This research examined how 13 landscape sites on a university campus might be differentially related to student well-being. These sites were identified from a variety of sources (campus design documents, photos used in the university's social media posts, and interviews with a small group of students) to represent a comprehensive list of places that students might visit. The data was collected in a large online survey of a Chinese university (n = 2,528). We asked about students' use of individual landscape sites and the associated motivations for visits, and measured well-being using a perceived stress scale and overall evaluation of the happiness level. Bivariate analysis was used to explore the zero-order associations between landscape use and well-being. OLS (for stress) and logistic regressions (for happiness) were conducted to further evaluate the associations after controlling the student background variables and potential correlations of uses across different landscapes.

RESULTS

Among 13 landscape sites, four sites had significant positive associations with either or both measures of well-being after controlling for the student characteristics and use of the other landscape sites. There was also an additive benefit of visiting more landscapes. Compared to those who did not frequently visit any of the sites, well-being had a significant stepwise increase among those who frequently visited one or two and more sites. One site that was significantly related to both measures of well-being only offered distant views of landscapes, but it was right next to the study areas.

CONCLUSIONS

This study demonstrates the heterogeneity of restorative effects across different landscapes on campus. The findings suggest that effective landscape design that aims to promote student well-being should be placed close to stressors (i.e., where they study), and between where they study and live to offer students opportunities to break from the common routines and to relax. The findings hold greater relevance for universities in China and institutions with similar student campus lifestyles, occupancies, and behavior patterns worldwide.

Risk factors for internalizing symptoms: The influence of empathy, theory of mind, and negative thinking processes

Internalizing symptoms such as elevated stress and sustained negative affect can be important warning signs for developing mental disorders. A recent theoretical framework suggests a complex interplay of empathy, theory of mind (ToM), and negative thinking processes as a crucial risk combination for internalizing symptoms. To disentangle these relationships, this study utilizes neural, behavioral, and self-report data to examine how the interplay between empathy, ToM, and negative thinking processes relates to stress and negative affect. We reanalyzed the baseline data of N = 302 healthy participants (57% female, Mage  = 40.52, SDage  = 9.30) who participated in a large-scale mental training study, the ReSource project. Empathy and ToM were assessed using a validated fMRI paradigm featuring naturalistic video stimuli and via self-report. Additional self-report scales were employed to measure internalizing symptoms (perceived stress, negative affect) and negative thinking processes (rumination and self-blame). Our results revealed linear associations of self-reported ToM and empathic distress with stress and negative affect. Also, both lower and higher, compared to average, activation in the anterior insula during empathic processing and in the middle temporal gyrus during ToM performance was significantly associated with internalizing symptoms. These associations were dependent on rumination and self-blame. Our findings indicate specific risk constellations for internalizing symptoms. Especially people with lower self-reported ToM and higher empathic distress may be at risk for more internalizing symptoms. Quadratic associations of empathy- and ToM-related brain activation with internalizing symptoms depended on negative thinking processes, suggesting differential effects of cognitive and affective functioning on internalizing symptoms. Using a multi-method approach, these findings advance current research by shedding light on which complex risk combinations of cognitive and affective functioning are relevant for internalizing symptoms.

Neuroenhancement and mental health in students from four faculties - a cross-sectional questionnaire study

Background

Students face great challenges at the beginning of and during their studies. Competitive experience, exam anxiety, and especially the new performance requirements often cause test anxiety and stressful experiences. The extent of substance use in terms of neuroenhancement (NE) is unclear. Evidence shows associations between NE, increased stress levels, and mental health.

Objectives

We aim to determine the prevalence of NE and alcohol and tobacco use among college students. We also investigate the associations between NE and ADHD, anxiety, depression, and stress experience.

Methods

In spring 2021, an anonymous online cross-sectional survey was conducted among students of medicine, dentistry, business economics, and business informatics in Würzburg. The survey included the instruments ASRS (ADHD), PSS-10 (stress), PHQ-4 (depression and anxiety), and AUDIT-C (alcohol comsumption), as well as questions about consumption patterns, prior knowledge, and reasons for NE.

Results

Of the 5564 students who were invited to participate, 1010 completed the questionnaire (18.2%). Of these, 12.4% indicated NE for the studied period. NE was used in particular during preparations for exams, to enhance performance, and/or to regulate emotions, most commonly through caffeine tablets, cannabis, and methylphenidate. NE was associated with risky use of alcohol or tobacco, and to a lesser extent with ADHD symptoms and stress experience.Conclusions: Students are at risk of substance abuse and NE. Effective stress management and prevention approaches as well as low-threshold services are needed to identify and support students with risk profiles.

Prevalence and correlates of depressive symptoms among matriculated university students in Singapore during Covid-19 pandemic: findings from a repeated cross-sectional analysis

BACKGROUND

Depression is a common issue among university students and has been particularly exacerbated during the COVID-19 pandemic. However, limited research has specifically focused on depression among university entrants.

OBJECTIVES

This study aimed to determine the prevalence of depression severity and identify associated factors during different phases of the COVID-19 pandemic using health screening questionnaires completed by matriculated university students in Singapore.

METHODS

A repeated cross-sectional study was conducted at a public university in Singapore. Data from health screening questionnaires administered in 2020 and 2021, involving 15,630 newly enrolled university students, were analyzed. The questionnaires covered students' sociodemographic information, physical health status, own and family medical history, lifestyle behaviours, and the Patient Health Questionnaire (PHQ-9). The PHQ-9 was used to measure the severity of depressive symptoms, categorizing into moderate to severe depressive symptoms (MSDS), mild depressive symptoms (MDS), or no depressive symptom (NDS). Multinomial logistic regression was used to assess the sociodemographic, physical and behavioural correlates of depression.

RESULTS

The prevalence of MSDS was 1% in both 2020 and 2021, while the rates for MDS were 1.93% in 2020 and 1.64% in 2021. In the 2020 cohort, male freshmen who reported better health had a lower likelihood of experiencing depression. Conversely, students of Malay ethnicity, those majoring in Engineering, those with multiple chronic diseases, monthly alcohol consumers, current smokers, and those with a family history of mental disorder had a higher likelihood of experiencing depression. Moreover, students who lived on-campus in the 2021 cohort were less likely to experience depression than those living off-campus. However, the associations between academic majors, alcohol consumption, and smoking with depression were not significant in the 2021 cohort.

CONCLUSIONS

This study reported a low prevalence of both MSDS and MDS among university entrants in Singapore. The study further identified three categories of factors associated with depression: sociodemographic, physical, and behavioural. This study suggests policy interventions to enhance targeted social support that address each student group's specific requirements and susceptibilities. A more extensive and comprehensive study is warranted to assess the changes in student mental health status post-COVID-19 pandemic.

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.

Mental Health and well-being During the COVID-19 Pandemic and After the Russian Invasion of Ukraine

The study compared the mental health of university students during the COVID-19 pandemic and the Russian invasion of Ukraine. A repeated online cross-sectional study was performed twice among university students in Ukraine: in November 2020 (Pre-war sample, n = 752) and September-October 2022 (During-war sample, n = 862). The survey measured life satisfaction (SWLS), perceived stress (PSS-10), anxiety (GAD-7), and depression (PHQ-9). Stress, anxiety, and life satisfaction levels were similar during the war and pandemic, while symptoms of depression decreased during the war, compared to the pandemic. Network analysis showed that anxiety has a crucial effect on depression and stress, and stress is most closely related to life satisfaction. The association of life satisfaction with anxiety and depression disappeared in wartime, in contrast to the pandemic. The priority of prevention and intervention programs in wartime Ukraine should focus on anxiety as the most influential factor in other mental health and well-being problems. The results showed high resistance and adaptation to war conditions among university students in Ukraine.

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.

Internet-delivered cognitive behavior therapy versus treatment as usual for anxiety and depression among Latin American university students: A randomized clinical trial

OBJECTIVE

Untreated mental disorders are important among low- and middle-income country (LMIC) university students in Latin America, where barriers to treatment are high. Scalable interventions are needed. This study compared transdiagnostic self-guided and guided internet-delivered cognitive behavioral therapy (i-CBT) with treatment as usual (TAU) for clinically significant anxiety and depression among undergraduates in Colombia and Mexico.

METHOD

1,319 anxious, as determined by the Generalized Anxiety Disorder-7 (GAD-7) = 10+ and/or depressed, as determined by the Patient Health Questionnaire-9 (PHQ-9) = 10+, undergraduates (mean [SD] age = 21.4 [3.2]); 78.7% female; 55.9% first-generation university student) from seven universities in Colombia and Mexico were randomized to culturally adapted versions of self-guided i-CBT (n = 439), guided i-CBT (n = 445), or treatment as usual (TAU; n = 435). All randomized participants were reassessed 3 months after randomization. The primary outcome was remission of both anxiety (GAD-7 = 0-4) and depression (PHQ-9 = 0-4). We hypothesized that remission would be higher with guided i-CBT than with the other interventions.

RESULTS

Intent-to-treat analysis found significantly higher adjusted (for university and loss to follow-up) remission rates (ARD) among participants randomized to guided i-CBT than either self-guided i-CBT (ARD = 13.1%, χ12 = 10.4, p = .001) or TAU (ARD = 11.2%, χ12 = 8.4, p = .004), but no significant difference between self-guided i-CBT and TAU (ARD = -1.9%, χ12 = 0.2, p = .63). Per-protocol sensitivity analyses and analyses of dimensional outcomes yielded similar results.

CONCLUSIONS

Significant reductions in anxiety and depression among LMIC university students could be achieved with guided i-CBT, although further research is needed to determine which students would most likely benefit from this intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mental health effects of social distancing in Switzerland

This analysis examines the effect of COVID-19 on public mental health in Switzerland. Following an event-study framework, we compare helpline call volume and duration before and after the outbreak of the first and second wave. The use of administrative phone-level data allows us to i) decompose the total effects into an intensive and extensive margin and ii) calculate a measure of unmet need. For the first wave, our results show that callers with a history of helpline contacts increase calls substantially. We also identify capacity constraints leading to unmet need for psychological counseling. Finally, we find no effects in the second wave, which might be explained by a number of factors including the absence of a lockdown and less restrictive social distancing measures.

The effect of childhood trauma on suicide risk: the chain mediating effects of resilience and mental distress

BACKGROUND

Suicide is the fourth leading cause of death among young people aged 15-29 years. A large number of studies have found that mental disorder in adulthood is closely related to childhood trauma, and the relationship between childhood trauma and suicide risk is influenced by resilience and mental distress. This study aimed to explore the effects of childhood trauma on suicide risk among young people and the potential roles of resilience and mental distress in the relationship between childhood trauma on suicide risk.

METHODS

A cross-sectional survey was conducted among 742 young adults who were in graduate school stage from multiple provinces and cities in China. The Childhood Trauma Questionnaire (CTQ-Short Form), Connor-Davison Resilience Scale (CD-RISC) and Suicide Behavior Questionnaire-Revised (SBQ-R) were used to measure young adults' childhood trauma, resilience and suicide risk, respectively. 9-items Patient Health Questionnaire (PHQ-9) and 7-items self-report Generalized Anxiety Disorder Scale (GAD-7) were used together to measure mental distress. Correlation analysis was performed to explore the initial relationships among the main variables. Structural equation modeling (SEM) was conducted to examine the chain mediating effects of resilience and mental distress in the relationship between childhood trauma and suicide risk.

RESULTS

The structural equation modeling produced goodness of fit indices (χ2 /df = 3.668, p < 0.001, RMSEA = 0.060, NFI = 0.959, CFI = 0.969, GFI = 0.969, TLI = 0.955). Childhood trauma significantly predicted suicide risk (β = 0.232, p < 0.001) and mental distress (β = 0.181, p < 0.001), which had negative effect on resilience (β = -0.233, p < 0.001). Resilience negatively affected mental distress (β = -0.483, p < 0.001) and suicide risk (β = -0.142, p = 0.001), while mental distress positively associated with suicide risk (β = 0.219, p < 0.001).

CONCLUSION

The current study revealed that resilience and mental distress played chain-mediating roles in the relationship between childhood trauma and suicide risk. This suggests that we should view the suicide risk of graduate students from a comprehensive perspective.

Integrating mindful self-hypnosis with resistance training to reduce stress: a case study

This case study explores the effects of a combined intervention involving Mindful Self-Hypnosis (MSH) and Resistance Training (RT) on perceived stress levels and well-being in a university student. The participant, Ms. P, engaged in a 12-week program comprised of two weekly RT sessions accompanied by MSH inductions. Perceived stress levels were evaluated using the Perceived Stress Scale (PSS), and well-being was assessed using the WHO-5 Well-Being Index. Intervention sessions were designed to enhance focus and calmness, along with imagery of performing the workout. Results from the case study reveal a notable reduction in Ms. P's perceived stress levels over the intervention period as indicated by a 30.8% decrease in PSS scores. Additionally, Ms. P demonstrated an improved strength in leg press 1-repetition maximum by an increased weight of 153.9%. This case study suggests that integrating MSH and RT may offer a beneficial strategy for stress reduction and enhancing well-being in university students. The findings underscore the potential applicability of this intervention to address stress-related challenges in this population. Future research with a larger sample size is needed to determine general efficacy of an MSH + RT intervention for stress reduction.

Mental health status and coping strategies during COVID-19 pandemic among university students in Central Serbia

Background

The objective of this research was to evaluate the occurrence of depression, anxiety, and stress, as well as the level of life contentment and coping mechanisms employed by college students amidst the COVID-19 pandemic.

Methods

A total of 588 students of the Faculty of Mechanical Engineering and the Higher School of Medicine, Kraljevo, University of Kragujevac, Central Serbia, participated in an online cross-sectional survey in the period September-October 2022. Depression Anxiety Stress Scales (DASS-21) was used to measure the levels of depression, anxiety, and stress. The Coping Questionnaire-a shorter version (Brief Cope Inventories) assesses the coping strategies a person uses in stressful situations, and the 5-item Life Satisfaction Scale is used to examine the level of life satisfaction.

Results

The symptoms of depression were reported by 34.9%, of anxiety by 47.1% and of stress by 44.2%. The type of faculty (p = 0.001), and place of residence (p = 0.036) correlated with depression, gender with anxiety (p = 0.001) and stress (p = 0.015). In terms of coping mechanisms, the most frequently mentioned strategies, based on average scores, were acceptance (5.76), positive interpretation (5.55), humor (5.46).

Conclusion

The adverse impact of COVID-19 was a risk factor for depression, anxiety and stress symptoms. A negative correlation exists between the levels of depression, anxiety, and stress, and the overall life satisfaction of university students. Offering the necessary assistance through psychological interventions and effective coping techniques is crucial in ensuring the optimal mental health of university students.

Investigating the mental health of university students during the COVID-19 pandemic in a UK university: a machine learning approach using feature permutation importance

Mental wellbeing of university students is a growing concern that has been worsening during the COVID-19 pandemic. Numerous studies have gathered empirical data to explore the mental health impact of the pandemic on university students and investigate factors associated with higher levels of distress. While the online questionnaire survey has been a prevalent means to collect data, regression analysis has been observed a dominating approach to interpret and understand the impact of independent factors on a mental wellbeing state of interest. Drawbacks such as sensitivity to outliers, ineffectiveness in case of multiple predictors highly correlated may limit the use of regression in complex scenarios. These observations motivate the underlying research to propose alternative computational methods to investigate the questionnaire data. Inspired by recent machine learning advances, this research aims to construct a framework through feature permutation importance to empower the application of a variety of machine learning algorithms that originate from different computational frameworks and learning theories, including algorithms that cannot directly provide exact numerical contributions of individual factors. This would enable to explore quantitative impact of predictors in influencing student mental wellbeing from multiple perspectives as a result of using different algorithms, thus complementing the single view due to the dominant use of regression. Applying the proposed approach over an online survey in a UK university, the analysis suggests the past medical record and wellbeing history and the experience of adversity contribute significantly to mental wellbeing states; and the frequent communication with families and friends to keep good relationship as well as regular exercise are generally contributing to improved mental wellbeing.

Natural language processing analysis of the psychosocial stressors of mental health disorders during the pandemic

Over the past few years, the COVID-19 pandemic has exerted various impacts on the world, notably concerning mental health. Nevertheless, the precise influence of psychosocial stressors on this mental health crisis remains largely unexplored. In this study, we employ natural language processing to examine chat text from a mental health helpline. The data was obtained from a chat helpline called Safe Hour from the "It Gets Better" project in Chile. This dataset encompass 10,986 conversations between trained professional volunteers from the foundation and platform users from 2018 to 2020. Our analysis shows a significant increase in conversations covering issues of self-image and interpersonal relations, as well as a decrease in performance themes. Also, we observe that conversations involving themes like self-image and emotional crisis played a role in explaining both suicidal behavior and depressive symptoms. However, anxious symptoms can only be explained by emotional crisis themes. These findings shed light on the intricate connections between psychosocial stressors and various mental health aspects in the context of the COVID-19 pandemic.

Psychological Health and Risk Factors of College Students within the Context of the COVID-19 Pandemic: A Cross-Sectional Study

BACKGROUND

Students are a priority population in mental health research. This study aimed to explore the risk factors of anxiety and depression symptoms among college students in Chongqing, a megacity under the impact of COVID-19, and to provide a basis for determining the priorities of public health policies and implementing effective educational health care interventions.

METHODS

In this cross-sectional study conducted in Chongqing, China, the data came from web-based stratified random sampling. Anxiety and depression symptoms were measured by the Self-Rating Anxiety Scale (SAS) and the Center for Epidemiological Studies Depression Scale (CES-D), respectively, and risk factors were analyzed by logistic regression.

RESULTS

Data were obtained from 915 college students (34.75% were male, and 65.25% were female) with age (20.29 ± 1.51) in Chongqing, China. The prevalence rates of anxiety and depression were 19.78% and 22.62%, respectively. Logistic regression analysis revealed that the risk factors of anxiety symptoms were associated with junior years, sleep time of less than 6 h a day, influence on career planning, and depression symptoms. Comprehensive, science and engineering, and medicine disciplines, having siblings, poorer mastery of study, and anxiety symptoms were risk factors for developing depression symptoms.

CONCLUSIONS

During the pandemic, college students experienced varying degrees of anxiety and depression. Our research findings highlight the necessity of universities and relevant departments providing precise mental health education for college students under major public health emergencies.

The mental health impact of the COVID-19 pandemic on post-secondary students: A longitudinal study

This prospective longitudinal study measured sex-specific changes in depression, anxiety, and stress scores using, validated Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Perceived Stress Scale (PSS) in a cohort of 1445 post-secondary students (500 males, 945 females) assessed at three time points from December 2020 to January 2022. Participants were ascertained from a population of 15,585 students with in-person activities on campus at baseline and recruited from December 2020 to January 2021. We also assessed how sociodemographic characteristics influenced students' mental health outcomes. Inverse probability weighting was used to account for missing data and attrition. Linear mixed effects models were used to analyze the relationship between the mental health scores in each questionnaire, demographic and academic data, and public health stringency measured by the local stringency index. No change was observed in questionnaire scores over time for males and females, but the stringency index was significantly associated with increased stress. Being in a non-health-related-field or being white affected males and females differently for stress and anxiety, but not depression. Demographics tended to be more influential on females' mental health than males. In conclusion, mental health resource allocation in time of emerging pandemic could benefit from targeted interventions.

Prevalence and incidence of depressive symptoms in pharmacy students: A systematic review

BACKGROUND

Pharmacy students are at high risk of developing depressive symptoms that can adversely influence their professional future. However, there are no summarized data on the subject.

OBJECTIVE

To summarize the prevalence and incidence of depressive symptoms in pharmacy students.

METHODS

A literature search was performed using PubMed, PsycINFO, CINAHL, LILACS, and SCOPUS databases until January 2022. We included observational studies that assessed the prevalence or incidence of depressive symptoms among pharmacy students using a validated screening instrument. Two independent investigators performed the study selection, data extraction, and quality assessment using the Joanna Briggs Institute (JBI) checklist for prevalence studies. The estimate of depressive symptoms was summarized as a narrative synthesis using structured tables.

RESULTS

Of the 695 records retrieved in the search, 19 studies met the eligibility criteria. All were cross-sectional studies, published between 2009 and 2022. The number of pharmacy students ranged from 30 to 610. Most studies were conducted in Asia (n = 9) and the Americas (n = 7), and included only public university students (n = 12). The studies used several instruments to screen students for depressive symptoms, mainly Patient Health Questionnaire-9 (n = 7), Beck Depression Inventory (n = 5), and Depression, Anxiety, and Stress Scale 21 (n = 4). Most studies (n = 15) evaluated only the prevalence of depressive symptoms. The estimate of overall, mild, moderate, and severe depressive symptoms ranged from 4.8% to 78.8%, 9.1% to 42.1%, 5.8% to 30.0%, and 0% to 50.0%, respectively. Regarding methodological quality, the score ranged from 4 to 7 out of 9 points according to the JBI checklist.

CONCLUSION

A high proportion of depressive symptoms were observed in pharmacy students. This finding points to the urgent need to develop strategies for screening, early identification of symptoms, and intervention to improve the mental health of students.

Comparison of prevalence of depression symptoms and history of suicidality in students of medical schools and other study programmes of Charles University

OBJECTIVES

Medical students represent a group of undergraduate students who are exposed to specific risk factors that may lead to the onset of depression and the occurrence of suicidal ideation. The aim of the article is to present information about the prevalence of symptoms of depression in medical students of different faculties at Charles University, Prague, compared to other students of this university.

METHODS

We used a standardized Beck's Inventory scale II (BDI-II) with added specific questions electronically distributed to undergraduate students of the full-time forms of study of all faculties of Charles University. The data collection was anonymous and took place in December 2020. The data were statistically assessed in relation to the occurrence of moderate and severe depression using univariate and multivariable analysis.

RESULTS

Moderate and severe depression rate (MSDR) was recorded in 19.6% of medical school students, who returned the questionnaire, compared to 23.4% of students of other faculties (p = 0.001) of Charles University in Prague. Differences in MSDR among students of different faculties of medicine of Charles University were not statistically significant. The total number of previous suicide attempts among respondents was 542, of which 115 were medical students, with the lifetime prevalence of suicide attempts among all students participating in the study 6.96% and in medical students of Charles University 5.73%.

CONCLUSIONS

The findings of our study highlight the need for systematic, accessible and timely assistance to university students, both in terms of prevention and early intervention, which can take place at the university level and within the mental healthcare system.

Sense of Coherence or resilience as predictors of psychological distress in nursing students during the COVID-19 pandemic

Background

The COVID-19 pandemic lead to the occurrence of numerous psychological distress among students. This study aimed to determine the level of psychological distress as well as the predictive role of Sense of Coherence (SOC) and resilience in nursing students.

Methods

A cross-sectional descriptive study was conducted on 310 nursing students in Ahvaz Jundishapur University of Medical Sciences, Iran. The data of the study was collected through the demographic information questionnaire, the General Health Questionnaire (GHQ), the Academic Resilience Inventory (ARI), and the Sense of Coherence Scale (SOC-13).

Results

Students' mean scores for the GHQ, ARI, and SOC were 5.81 ± 1.37, 102.88 ± 11.91, and 54.54 ± 6.46, respectively. Regression models showed that two domains of SOC [meaningfulness (β = -0.28, p < 0.001), manageability (β = -0.19, p = 0.001)], female gender (β = 0.12, p = 0.015), and overall ARI (β = -0.12, p = 0.037), were significantly associated with the GH of nursing students. SOC domains [meaningfulness (β = -0.19, p = 0.002), manageability (β = -0.15, p = 0.006)], problem-oriented/positive thinking domain of ARI (β = -0.15, p = 0.011), sex (β = 0.12, p = 0.015), and history of death in first-degree relatives (β = 0.12, p = 0.021) were significantly associated with social dysfunction domain of GH. Three domains of SOC [meaningfulness (β = -0.26, p < 0.001), manageability (β = -0.13, p = 0.032), and comprehensibility (β = -0.13, p = 0.039)], were significantly associated with psychological distress domain of GH.

Conclusion

Our results indicated that low SOC and resilience were predictors of psychological distress in nursing students. Accordingly, interventions such as teaching stress management skills, the skills of using positive coping methods in dealing with stressful situations, and self-management skills are necessary to improve the level of resilience and SOC in nursing students.

Determinants of the mental health status of university students in Japan: comparison between pandemic and recession periods during the 7th wave of COVID-19

Introduction

Although the number of identified coronavirus disease 2019 (COVID-19) cases and deaths has decreased, the repetitive crest-trough pattern of the spread of COVID-19 has yet to cease. The current situation may affect the mental health status of university students who are distracted in their academic and daily lives by the pandemic. This cross-sectional study aimed to identify the determinant factors of the mental health status of Japanese university students before and in the middle of the 7th wave of the pandemic, one of the largest waves to be experienced in Japan.

Method

A survey was administered to two groups of students during the recession period between the 6th and 7th waves (n = 156) and during the 7th wave of the pandemic (n = 97).

Results

T-tests showed no statistically significant differences between the two groups in Perceived Stress Scale (PSS) scores, while the COVID-19 anxiety scores (p < 0.001) and General Health Questionnaire (GHQ) scores were significantly higher in the Pandemic period group (p = 0.011). The multiple regression model indicated that PSS scores were the only determinant of GHQ scores in the Pandemic period group.

Discussion

The results indicate that stressful life events, such as the COVID-19 pandemic and daily hassles, which are measured by the PSS, affect students' mental health differently. Therefore, the author submits that school counselors should provide counseling to students to reduce anxiety caused by daily hassles, during recession and pandemic periods. Students also require assistance with the reduction of stress and anxiety caused by daily hassles, regardless of the pandemic situation.

An application of ordinal regression to extract social dysfunction levels through behavioral problems

Psychological problems are complex in nature and accurate identification of these problems is important. For the identification of psychological problems, one of the preliminary tools is the use of interviews/questionnaires. Questionnaires are preferred over interviews if the group under study is large. A strengths and difficulties questionnaire (SDQ) is one of the most widely used and powerful questionnaires to identify behavioral problems and distresses being faced by the respondents, affecting their day-to-day lives (responsible for social dysfunction). This study was held on college/university students in India, with the objective of examining if the extent of social dysfunction as measured by an impact score can be extracted from behavioral problems which are the components of the difficulty score of SDQ. Two surveys were conducted during the COVID-19 pandemic period, between the months of May-June 2020 and October 2020-February 2021 for the study. Only those responses were considered who felt distressed ("yes" to item 26 of SDQ). The numbers of such responses were 772/1020 and 584/743, respectively, in the two surveys. Distress levels were treated as ordered variables and three categories of distress level, viz., "Normal", "Borderline", and "Abnormal" were estimated through behavioral problems using ordinal regression (OR) methods with a negative log-log link function. The fitting of OR models was tested and accepted using Cox and Snell, Nagelkerke, and McFadden test. Hyperactivity-inattention and emotional symptoms were significant contributors to estimating levels of distress among respondents in survey 1 (p < 0.05). In addition to these components, in survey 2, peer problems were also significant. OR models were good at estimating the extreme categories; however, the "Borderline" category was not estimated well. One of the reasons was the use of qualitative and complex data with the least wide "Borderline" category, both for the "Difficulty" and the "Impact" scores.

Mental distress and well-being of university students amid COVID-19 pandemic: findings from an online integrative intervention for psychology trainees

Introduction

University students have been severely affected by the COVID-19 pandemic, as significant changes supervened their academic and social life. To tackle these challenges, several adjustments in the educational methods may be warranted for cultivating a positive environment at higher education institutions. The aim of this study was to investigate the risk and protective factors of students' mental health and well-being as well as their potential for flourishing in an undergraduate clinical psychology course that took place online due to the COVID-19 restrictive measures and incorporated positive psychology exercises as a means to empower young people amid the adverse conditions of the lockdown.

Methods

In total, 124 students attended the course and completed mental health (i.e., DASS-9, HADS, ERQ) and well-being (i.e., MHC-SF, SWLS, PANAS, GQ-6, BRS) measures at two time points (pre-and-post-test), during the first restrictions in Greece (March-June 2020).

Results

According to the results, students aged 18-20 years old reported higher levels of stress [χ² = 14.72, p = 0.002], while students who felt that the quality of their studies had deteriorated [χ² = 6.57, p = 0.038] reported increased levels of anxiety. High levels of depression were correlated with worse relationships with significant others (z = 7.02, p = 0.030 and χ² = 11.39, p = 0.003 for family and friends, respectively), while gratitude and resilience were positively correlated with improved relationships with others, both during and after the lockdown. Factors associated with students' well-being were satisfaction with life and gratitude.

Discussion

These results suggest that well-being enhancement factors may have added value to current educational practices for promoting students' mental health and well-being in times of crisis.

Braving the waves: exploring capability well-being patterns in seven European countries during the COVID-19 pandemic

The COVID-19 pandemic considerably impacted the lives of European citizens. This study aims to provide a nuanced picture of well-being patterns during the pandemic across Europe with a special focus on relevant socio-economic sub-groups. This observational study uses data from a repeated, cross-sectional, representative population survey with nine waves of data from seven European countries from April 2020 to January 2022. The analysis sample contains a total of 25,062 individuals providing 64,303 observations. Well-being is measured using the ICECAP-A, a multi-dimensional instrument for approximating capability well-being. Average levels of ICECAP-A index values and sub-dimension scores were calculated across waves, countries, and relevant sub-groups. In a fixed effects regression framework, associations of capability well-being with COVID-19 incidence, mortality, and the stringency of the imposed lockdown measures were estimated. Denmark, the Netherlands, and France experienced a U-shaped pattern in well-being (lowest point in winter 2020/21), while well-being in the UK, Germany, Portugal, and Italy followed an M-shape, with increases after April 2020, a drop in winter 2020, a recovery in the summer of 2021, and a decline in winter 2021. However, observed average well-being reductions were generally small. The largest declines were found in the well-being dimensions attachment and enjoyment and among individuals with a younger age, a financially unstable situation, and lower health. COVID-19 mortality was consistently negatively associated with capability well-being and its sub-dimensions, while stringency and incidence rate were generally not significantly associated with well-being. Further investigation is needed to understand underlying mechanisms of presented patterns.

Depression, Anxiety and Stress Associated With Fear of COVID-19 in Peruvian Dental Students: A Multivariate Analysis With 12 Sociodemographic Factors

Aims and Objectives

Excessive fear of coronavirus disease 2019 (COVID-19) in dental students could cause mood disorders, especially if there are factors in the environment that generate feelings of anxiety or uncertainty. The aim of this study was to evaluate the fear of COVID-19 and its association with depression, anxiety, and stress in Peruvian dental students according to their sociodemographic factors.

Materials and Methods

This analytical, observational, and cross-sectional study was conducted in 398 dental students of a public university in the Peruvian capital during April 2021 to July 2021. The Depression, Anxiety and Stress Scale-21 items was used to diagnose depression, anxiety, and stress. The Fear of COVID-19 Scale was used to detect fear of COVID-19. The Pearson's chi-square test was used for statistical analysis. In addition, a logit model using odds ratio (OR) was performed to evaluate depression, anxiety, and stress of students with the associated factors: fear of COVID-19 and 12 sociodemographic variables (gender, age group, marital status, year of study, origin, companion, living with vulnerable people, history of mental illness, history of COVID-19, loss of close relatives due to COVID-19, occupation, and area of residence). A significance level of P < .05 was considered. In addition, predictive models were developed for the variables depression, anxiety, and stress, considering all possible significant causes.

Results

The prevalence of fear of COVID-19, depression, anxiety, and stress was 19.6%, 36.2%, 40.7%, and 19.6%, respectively. According to the adjusted logit model, students who had fear of COVID-19 had OR = 2.74 (95% confidence interval [CI]: 1.62-4.64), OR = 5.59 (95% CI: 3.14-9.97), and OR = 3.31 (95% CI: 1.88-5.83) for developing depression, anxiety, and stress, respectively. In addition, those who reported history of mental illness were four times more likely to develop depression (OR = 4.02, 95% CI: 1.96-8.25) and anxiety (OR = 4.50, 95% CI: 2.06-9.82), whereas those living with people vulnerable to COVID-19 were twice as likely to develop stress (OR = 2.06, 95% CI: 1.16-3.66).

Conclusion

The highest prevalence of mood disorders among dental students was anxiety. In addition, those who were afraid of COVID-19 had three times the probability of developing depression and stress, and five times the probability of developing anxiety. On the other hand, the most influential factor in the development of depression and anxiety was history of mental illness, whereas the factor of living with vulnerable people was the most influential factor in the development of stress.

The pandemic not only increased depression and PTSD in college students, but also changed how they categorize emotions

Objective: In March 2020, the emergence of COVID-19 as a pandemic prompted large scale, social lockdowns internationally. Participants/Method: Here, we compared the mental health symptoms and social functioning of pre-pandemic college students collected during the Spring 2020 semester to those of a pandemic group collected during the Fall 2020 semester. Results: Results reveal that students assessed during the pandemic reported more severe symptoms of posttraumatic stress and depression, yet no difference in anxiety symptoms, relative to students assessed before the pandemic. Furthermore, students assessed during the pandemic conceptualized and categorized their emotions with significantly more neutral emotions and significantly fewer positive emotions, yet no difference in negative emotions, relative to students assessed before the pandemic. Despite these mental health effects, we found no difference between the two groups in self-reported social functioning. Conclusion: Overall, these results suggest young adults' mental health was significantly impacted by the pandemic, with the potential for long lasting effects.

COVID-19 Phobia among Korean, Chinese, and Japanese students: An international comparative study

This study aimed to identify the characteristic differences and potential contributing factors of coronavirus disease 2019 (COVID-19) phobia between undergraduate and graduate students in Korea, Japan, and China. We used the online survey tool, we retained 460 responses from Korea, 248 responses from Japan, and 788 responses from China for analysis. We performed the statistical analysis; ANOVA F-test and Multiple linear regression. We visualized the results of these calculations using GraphPad PRISM 9. The mean COVID-19 phobia score was highest in Japan at 50.5 points. Psychological fear was identically prevalent in Japan and China, at an average of 17.3 points. Psychosomatic fear was highest in Japan at 9.2 points. Further, economic fear was highest in Korea at 13 points, whereas social fear was highest in China at 13.1 points. In Korea, COVID-19 phobia scores were significantly higher among women than in men. In Japan, COVID-19 phobia scores were significantly higher in individuals who complied with social distancing mandates. In China, a lack of previous experience with self-administered testing kits was associated with significantly lower phobia scores. Individuals who were avoiding crowded places had significantly higher scores in 3 countries. This implies that the students knew that it was necessary to comply with COVID-19 preventive behaviors to prevent infections. The findings of this study could be used as a reference when establishing an approach strategy to reduce COVID-19 phobia among Chinese, Japanese, and Korean students.

COVID-19 pandemic effects on college student mental health: A cross-sectional cohort comparison study

OBJECTIVE

Evaluate COVID-19 pandemic impacts on college student mental health.

PARTICIPANTS

Three cohorts of college students (2018 n = 466; 2019 n = 459; 2020, n = 563; N = 1488) from three American universities. Participants were 71.4% female, 67.5% White, and 85.9% first-year students.

METHODS

Multivariable regression models and bivariate correlations were used to compare anxiety, depression, well-being, and search for meaning before and during the pandemic, and the relationships between pandemic health-compliance behaviors and mental health.

RESULTS

Anxiety, depression, and well-being did not significantly worsen during compared to before (2019) the pandemic (ps = .329-.837). During the pandemic, more frequent in-person social interactions were correlated with lower anxiety (r = -0.17, p < .001) and depressive symptoms (r=-0.12, p = .008), and higher well-being (r = 0.16, p < .001), but also less handwashing (r = -0.11, p = .016) and face mask-wearing (r = -0.12, p = .008).

CONCLUSIONS

We observed little evidence for pandemic impacts on college student mental health. Lower compliance with pandemic health guidelines was associated with better mental health.

COVID-19 Policies, Pandemic Disruptions, and Changes in Child Mental Health and Sleep in the United States

IMPORTANCE

The adverse effects of COVID-19 containment policies disrupting child mental health and sleep have been debated. However, few current estimates correct biases of these potential effects.

OBJECTIVES

To determine whether financial and school disruptions related to COVID-19 containment policies and unemployment rates were separately associated with perceived stress, sadness, positive affect, COVID-19-related worry, and sleep.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study was based on the Adolescent Brain Cognitive Development Study COVID-19 Rapid Response Release and used data collected 5 times between May and December 2020. Indexes of state-level COVID-19 policies (restrictive, supportive) and county-level unemployment rates were used to plausibly address confounding biases through 2-stage limited information maximum likelihood instrumental variables analyses. Data from 6030 US children aged 10 to 13 years were included. Data analysis was conducted from May 2021 to January 2023.

EXPOSURES

Policy-induced financial disruptions (lost wages or work due to COVID-19 economic impact); policy-induced school disruptions (switches to online or partial in-person schooling).

MAIN OUTCOMES AND MEASURES

Perceived stress scale, National Institutes of Health (NIH)-Toolbox sadness, NIH-Toolbox positive affect, COVID-19-related worry, and sleep (latency, inertia, duration).

RESULTS

In this study, 6030 children were included in the mental health sample (weighted median [IQR] age, 13 [12-13] years; 2947 [48.9%] females, 273 [4.5%] Asian children, 461 [7.6%] Black children, 1167 [19.4%] Hispanic children, 3783 [62.7%] White children, 347 [5.7%] children of other or multiracial ethnicity). After imputing missing data, experiencing financial disruption was associated with a 205.2% [95% CI, 52.9%-509.0%] increase in stress, a 112.1% [95% CI, 22.2%-268.1%] increase in sadness, 32.9% [95% CI, 3.5%-53.4%] decrease in positive affect, and a 73.9 [95% CI, 13.2-134.7] percentage-point increase in moderate-to-extreme COVID-19-related worry. There was no association between school disruption and mental health. Neither school disruption nor financial disruption were associated with sleep.

CONCLUSIONS AND RELEVANCE

To our knowledge, this study presents the first bias-corrected estimates linking COVID-19 policy-related financial disruptions with child mental health outcomes. School disruptions did not affect indices of children's mental health. These findings suggest public policy should consider the economic impact on families due to pandemic containment measures, in part to protect child mental health until vaccines and antiviral drugs become available.

From Academic Resilience to Academic Burnout among International University Students during the Post-COVID-19 New Normal: An Empirical Study in Taiwan

(1) Background: In the context of the COVID-19 pandemic, it is imperative for higher education institutions to understand the socio-psychological issues of international students, a potentially vulnerable population on campuses, to assist them in pursuing their academic path while maintaining their psychological well-being. The objectives of this study were to determine the prevalence of academic burnout among international university students in Taiwan during the new normal and to explore the protective role of academic resilience. (2) Methods: Three hundred and eighty-three international university students in Taiwan were recruited and surveyed via the online self-administered questionnaire during the Fall semester of the 2022–2023 academic year. The data of sociodemographic characteristics, academic burnout, and academic resilience were collected and analyzed. (3) Results: The overall prevalence of high academic burnout was 12.01%. The majority of participants perceived significant depression and anxiety (detrimental factors) but moderate to high perception of academics and relationships (protective factors). There were significant relationships between resilience components and burnout symptoms. (4) Conclusions: Resilience may help to reduce burnout among international university students during the post-COVID-19 new normal, thereby protecting their mental health.

Understanding University Students during COVID-19: A Longitudinal Mixed-Methods Analysis of Their Experiences of Online Learning, Mental Health, Academic Engagement, and Academic Self-Efficacy

INTRODUCTION

Research has consistently demonstrated that the COVID-19 pandemic, and resulting sudden shift to online learning (OL), had detrimental impacts on the motivation and mental health of university students. To date however this research has been cross-sectional and quantitative.

METHOD

This study employed a mixed-methods design to examine the experiences of students at a large national Australian University both at the outset of the pandemic in 2020 (n = 824) and again 6 months later (n = 254) at the conclusion of their academic year.

RESULTS

Key findings from this study highlighted that despite quantitative findings suggesting poorer attitudes toward learning during the pandemic, qualitatively students perceived both positives and negatives to studying online. The qualitative results further highlighted that this experience was not the same for all and suggests the need to reconsider the standard approaches to offering support for students.

CONCLUSION

Students reported poor mental health in both time points, but outlined avenues which improved not only their mental health but also their motivation for studying such as increased peer engagement and self-care activities. Students reported that OL negatively impacted on both their engagement with studies and their mental health, highlighting the need for universities to prioritize supporting their students' mental health as much as their development of academic skills.

"Managing emotion": Open label trial and waitlist controlled trial of an emotion regulation program for university students

Background: More than one-third of university students meet diagnostic criteria for a mental disorder, and three quarters experience role impairment in some aspect of their life. One determinant of whether young adults will experience mental health difficulties is their ability to regulate emotion. We conducted two pilot trials of a brief online program designed to teach emotion regulation skills to university students. Methods: In Study 1, we conducted an open-label trial (n = 104). In Study 2, we conducted a waitlist controlled trial (n = 167). In both studies, pre- and post-assessment of emotion regulation, psychological distress, and self-compassion were conducted. Results: In both trials, we observed improvements in emotion regulation, and reductions in symptoms of psychological distress. Acceptability and feasibility were also satisfactory. Conclusion: An online emotion regulation program may offer promise in improving emotion regulation and subsequent mental health concerns among university students. (ACTRN12620000390987; ACTRN12620000839909).

The role of social support and sociocultural adjustment for international students' mental health

The study aims to assess the role of social support, sociocultural adjustment, and other social and demographic factors in international students' mental health. In total, 193 international first-year students studying Health and Technology Sciences in Lithuania filled out a self-report questionnaire. The study revealed that overall 59% of international students had symptoms of depression and 36%-of anxiety. Students' well-being was sufficient in 56% of the cases. The regression analyses were conducted to test the role of sociocultural adjustment, social support, English reading skills, and the study field for mental health and well-being. The multivariate regression model revealed that sociocultural adjustment is a stronger predictor compared to social support for depressiveness (βs = 0.42), anxiety (βs = 0.30), psychosomatic symptoms (βs = - 0.24), and subjective health (βs = 0.16), though social support was a stronger independent predictor for well-being (βs = 0.37). Moreover, sociocultural adjustment and social support were stronger predictors than gender, while English reading skills and study field were non-significant indicators.

Generalized anxiety disorder in Berlin school children after the third COVID-19 wave in Germany: a cohort study between June and September 2021

BACKGROUND

During the COVID-19 pandemic, children and adolescents worldwide have disproportionally been affected in their psychological health and wellbeing. We conducted a cohort study among German school children, aiming at assessing levels of general anxiety disorder (GAD) and identifying associated factors in the second pandemic year.

METHODS

A cohort of 660 students from 24 Berlin schools was recruited to fill in questionnaires including the GAD-7 tool on anxiety symptoms at three time points between June and September 2021. To adjust for non-random attrition, we applied inverse probability weighting. We describe reported GAD levels stratified by time point, sex, and school type and report odds ratios from univariate logistic regression.

RESULTS

In total, 551 participants (83%) filled in at least one questionnaire at any time point. At the first time point in June 2021, 25% of the children and adolescents reported anxiety symptoms with a GAD-7 score ≥ 5, decreasing to 16% in August 2021 directly after the summer holidays and rising again to 26% in September 2021. The majority of reported anxiety levels belonged to the least severe category. Being female, attending secondary school, coming from a household with lower education or with lower income level, and being vaccinated against COVID-19 were significantly linked with reporting anxiety symptoms. Preceding COVID-19 infection and anxiety were negatively associated.

CONCLUSION

Overall, anxiety in school children was lower in mid-2021 than in the first pandemic year, but still double compared to pre-pandemic data. Reporting of anxiety symptoms during the second pandemic year was especially high in females and in secondary school students. Policy makers should pay additional attention to the mental health status of school children, even as the pandemic situation might stabilize.

Factors associated with psychological distress during the COVID-19 pandemic: Data from two early waves in Russia

There is limited information about how the mental health of people has changed over time during the COVID-19 pandemic in low- and middle-income countries. In a cross-sectional study, we identified factors associated with psychological distress at two periods immediately after two peaks of the COVID-19 pandemic in Russia. Data were collected via online surveys. In May-June 2020, we surveyed 373 respondents across Russia. In January-February 2021, we surveyed 743 people, using the same approach for survey distribution. With Kessler-10 as a measure of psychological distress, we used regression analysis to determine factors associated with higher psychological distress among Russians. Levels of psychological distress were high in both time periods and did not significantly change between the surveys. Having had COVID-19, losing one's job, experiencing problems accessing healthcare, and changing drinking behaviour during the pandemic were associated with higher psychological distress. Apart from getting sick or worrying about the virus, psychological distress is affected by restrictions and the consequences of the pandemic situation. As the COVID-19 pandemic continues, actions are needed to address the mental well-being of the population in Russia.

The rapid change in mental health among college students after introduction of on-campus quarantine during the 2022 Shanghai COVID-19 lockdown

Objectives

Among the various impacts of disasters in terms of emotions, quarantine has been proven to result in significant increases in mental health problems. Studies of psychological resilience during outbreaks of epidemics tend to focus on long-term social quarantine. In contrast, insufficient studies have been conducted examining how rapidly negative mental health outcomes occur and how these outcomes change over time. We evaluated the time course of psychological resilience (over three different phases of quarantine) among students at Shanghai Jiao Tong University to investigate the influence of unexpected changes on college students.

Methods

An online survey was conducted from 5 to 7 April 2022. A structured online questionnaire was administered using a retrospective cohort trial design. Before 9 March (Period 1), individuals engaged in their usual activities without restrictions. From 9 to 23 March (Period 2), the majority of students were asked to remain in their dormitories on campus. From 24 March to early April (Period 3), restrictions were relaxed, and students were gradually allowed to participate in essential activities on campus. We quantified dynamic changes in the severity of students' depressive symptoms over the course of these three periods. The survey consisted of five sets of self-reported questions: demographic information, lifestyle/activity restrictions, a brief mental health history, COVID-19-related background, and the Beck Depression Inventory, second edition.

Results

A total of 274 college students aged 18-42 years (mean = 22.34; SE = 0.24) participated in the study (58.39% undergraduate students, 41.61% graduate students; 40.51% male, 59.49% female). The proportion of students with depressive symptoms was 9.1% in Period 1, 36.1% in Period 2, and 34.67% in Period 3. Depressive symptoms increased notably with the introduction of the quarantine in Periods 2 and 3. Lower satisfaction with the food supplied and a longer duration of physical exercise per day were found to be positively associated with changes in depression severity in Periods 2 and 3. Quarantine-related psychological distress was more evident in students who were in a romantic relationship than in students who were single.

Conclusion

Depressive symptoms in university students rapidly increased after 2 weeks of quarantine and no perceptible reversal was observed over time. Concerning students in a relationship, ways to take physical exercise and to relax should be provided and the food supplied should be improved when young people are quarantined.

The effects of sustained COVID-19 emergency and restrictions on the mental health of subjects with serious mental illness: A prospective study

Few longitudinal studies have so far investigated the impact of sustained COVID-19 among people with pre-existing psychiatric disorders. We conducted a prospective study involving people with serious mental illness (n = 114) and healthy controls (n = 41) to assess changes in the Perceived Stress Scale, Generalized Anxiety Disorder Scale, Patient Health Questionnaire, and Specific Psychotic Experiences Questionnaire scores 18 months after the COVID-19 pandemic outset. Subjects underwent interviews with a mental health professional in April 2020 and at the end of the local third wave (October 2021). A significant increase in perceived stress was found in healthy controls, especially females. Psychiatric patients showed a significant worsening of anxiety symptoms compared to baseline records (t = -2.3, p = 0.036). Patients who rejected vaccination had significantly higher paranoia scores compared to those willing to get vaccinated (U = 649.5, z = -2.02, p = 0.04). These findings indicate that COVID-19's sustained emergency may cause enduring consequences on mental health, soliciting further investigations.

Effects of Online Mindfulness-Based Interventions on Depressive Symptoms in College and University Students: A Systematic Review and Meta-Analysis

Introduction: Depression is considered a multiproblematic disorder that leads to impairment in interpersonal, academic, social, and occupational functioning. Untreated depression can lead to suicide, which is the second leading cause of death among adolescents and young adults. Antidepressants and psychotherapy have limited effectiveness and are not available worldwide. Alternative and complementary treatments, such as online mindfulness-based interventions (MBIs), are growing. Objective: We examined the effects of online MBIs on depressive symptoms in college and university students and explored the moderating effects of participant, methods, and intervention characteristics. Methods: We systematically searched nine databases from their inception through August 2022 without date restrictions. We included primary studies evaluating MBIs with college and university students with depression measured as an outcome, a comparison group, that were written in English. We used random-effects model to compute effect sizes (ESs) using Hedges' g, a forest plot, and Q and I² statistics as measures of heterogeneity; we also examined moderator analyses. Results: Fifteen studies included 1886 participants (22.6 ± 3.2 years old). Overall, online MBIs showed significantly improved depression (g = 0.18, 95% confidence interval 0.02 to 0.34, I² = 61%) compared with controls. With regard to moderators, when depression was measured further from the end of the intervention, there was less reduction in depressive symptoms (β = -0.012, Q_model = 3.81, p = 0.051). Researchers who reported higher attrition reported less beneficial effects on depressive symptoms (β = -0.013, Q_model = 9.85, p = 0.001). Researchers who used intention-to-treat reported lower ESs (g = -0.15) compared with not using intention-to-treat (g = 0.32, p < 0.001). No other quality indicators moderated the effects of online MBIs on depression. Conclusions: Online MBIs improved depressive symptoms in college and university students. Thus, it might be used as one treatment in their tool kit for college and university students.

Association between sleep patterns, somatization, and depressive symptoms among Russian university students

In adolescents and young adults, physical and mental health are known to be associated with sleep. In this paper, we consider the connection between health indicators and sleep patterns. We collected and analyzed data of 267 master's and bachelor's degree students from 21 educational programs at one elite Russian university. Somatic health and mental health were measured using, respectively, the 8-item and the 15-item Patient Health Questionnaire, and sleep patterns were identified using the Munich Chronotype Questionnaire. The results indicated that shorter sleep time, later bedtime, and later rising time on workdays were associated with student somatic health. Shorter sleep on workdays was positively associated with the severity of depressive symptoms. Our findings highlight the importance of healthy sleep behavior for student health.

Higher Prevalence of Food Insecurity and Psychological Distress among International University Students during the COVID-19 Pandemic: An Australian Perspective

The COVID-19 pandemic and related disruptions have not only affected university students' learning and academic outcomes, but also other issues, such as food security status, mental health and employment. In Australia, international students faced additional pressures due to sudden border closures and lack of eligibility for government-provided financial support. This study explored the experiences of domestic and international university students residing in Australia during the early stages of the COVID-19 pandemic across a range of outcomes. A cross-sectional online survey was conducted between July and September 2020 at Macquarie University in Sydney, Australia. The online survey included food insecurity status, mental health (psychological distress), disruptions to study, employment and sleep. A total of 105 students (n = 66 domestic and n = 39 international) completed the survey. Respondents reported having food insecurity (41.9%) and psychological distress (52.2%, with high and very high levels), with international students reporting significantly higher food insecurity (OR = 9.86 (95% CI 3.9-24.8), p < 0.001) and psychological distress scores (t(90) = 2.68, 95% CI: 1.30 to 8.81, p = 0.009) than domestic students. About one quarter of all respondents reported disruptions to study and employment status around the time of the survey. When asked what government support should be provided for international students, 'financial aid' was the most frequently suggested form of support. This research may help governments and educational institutions design appropriate support, particularly financial and psychological, for both international and domestic university students.

Remote Interventions to Support Students' Psychological Well-Being during the COVID-19 Pandemic: A Narrative Review of Recent Approaches

The COVID-19 pandemic has negatively affected students' mental health, and it is important to implement mental health management strategies. The purpose of this study was to present current findings on the implementation of remote mental health interventions in students during the pandemic. The PubMed and Web of Science electronic databases were searched and, from a total of 174 articles, 106 records were excluded according to the inclusion criteria and 23 were assessed as full texts. After the full-text screening, 12 studies were included in the review. The included publications were randomized clinical trials focused on remote mental support interventions among students from 10 countries, representing both genders, and were in the average age range of 17-55 years with an overall number of 892 participants. The included studies covered the effectiveness of strictly psychotherapeutic programs, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), as well as other techniques such as mindfulness, laughter therapy, the brain wave modulation technique (BWM-T), and physical activity-based interventions. This narrative review provides an overview of studies with a wide range of types of remote mental health support interventions. Each of the forms of intervention analyzed in this review resulted in positive changes in students' mental health, which indicates hope for widespread help via various forms of intervention implemented remotely.

Trajectories and predictors of vicarious traumatization in Chinese college students during the COVID-19 pandemic: A longitudinal study

Objectives

This longitudinal study aimed to identify the trajectories and the predictors among sociodemographic and psychosocial variables at baseline of vicarious traumatization (VT) in Chinese college students during the COVID-19 pandemic.

Materials and methods

A total of 544 Chinese college students enrolled in a public University in central China, majored in Clinical Medicine, Nursing, Musicology, Physics, etc., participated in this longitudinal study lasting 19 months. Three-wave (wave 1: February 2020; wave 2: November 2020; wave 3: September 2021) of data were collected. Resourcefulness Scale and the 10-item Kessler scale (K10) were only assessed in the first-wave survey, and the Event Scale-Revised (IES-R) was repeatedly measured in all three-wave surveys. A link to an online survey created by Questionnaire Star (https://www.wjx.cn/) was sent to the students to collect data. The Growth mixture modeling (GMM) and multiple logistic regression were used to identify the trajectories of VT and predictors for the distinct trajectories.

Results

The incidence of VT at each wave varied from 9.9% at wave 1, 4.0% at wave 2, to 2.6% at wave 3. Three trajectories of VT were the medium-level escalating group (3.0%), medium-level maintaining group (32.3%), and the low-level descending group (64.7%). Seniors (OR = 1.575, 95% CI: 1.059-2.341; OR = 1.161, 95% CI: 1.043-1.293) and those with poor mental health status (OR = 1.101, 95% CI: 1.030-1.177; OR = 1.083, 95% CI: 1.060-1.106) at baseline were more likely to be classified into the medium-level escalating group and medium-level maintaining group, respectively. Additionally, females (OR = 3.601, 95% CI: 1.311-9.887) were more likely to be included in the medium-level escalating group.

Conclusion

Targeted psychological interventions are urgently needed for students vulnerable to VT. Further studies with more representative samples, longer period of follow-up, and predictors based on scientific theoretical framework, are needed to update the findings.

International medical students' acculturation and self-rated health status in Hungary: a cross-sectional study

Background

Over the past few decades, the number of international students has increased dramatically. These students have to adjust to unfamiliar social, cultural, and educational environments. The concept of acculturation has been applied in multiple studies on various health outcomes. This study investigated the relationship between acculturation and self-rated health (SRH) among international medical students.

Methods

A cross-sectional study was conducted among international medical students at the University of Szeged, Hungary between April and October 2021. A total of 326 participants filled out questionnaires about sociodemographic characteristics, acculturation, and SRH. The modified Stephenson multigroup acculturation scale (SMAS) was used to assess the acculturation status; the scale defined acculturation as the degree of dominant society immersion (DSI, 12 items) and ethnic society immersion (ESI, 16 items). To measure SRH, participants were asked to rate their current general health and mental health. The data were analyzed by using descriptive statistics and the multiple logistic regression model.

Results

32.5% of the students reported having poor general and 49.7% poor mental health. We have found that acculturation was associated with SRH in multivariable logistic regression models controlling for sociodemographic characteristic. Bidimensional acculturation, such as ESI and DSI significantly influenced SRH as the likelihood of poor general health decreased (OR = 0.50; 95% CI = 0.31–0.81, P = 0.005), when the ESI was higher, whereas the likelihood of poor mental health decreased (OR = 0.52; 95% CI = 0.35–0.79, P = 0.002) if students had a greater DSI.

Conclusion

Both types of immersion can affect the students’ SRH. If the student could integrate better into their own ethnic group, their general health was better, and if they could strongly integrate into the Hungarian society, their mental health was more favorable. Acculturation measures should be promoted by academics and public health professionals in order to better understand their role in the behaviors, health outcomes, and health care use of medical international students. These findings will help professionals shape culturally sensitive prevention and counselling strategies for international student populations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14334-y.

COVID-19 and Mental Health of Minority Arab Higher-Education Students in Israel: Social, Economic, and Academic Factors

The mental health and well-being of higher-education students is a topic of growing interest. COVID-19 impacted higher education in many ways and the challenges were especially pronounced for minority students. This study examines the impact of COVID-19 on the mental health of Arab minority students in Israel in relation to social, academic, and financial factors. We recruited 420 Arab higher-education students enrolled in academic colleges or universities in Israel who completed a battery of online questionnaires. Mental health status was measured by the Depression, Anxiety, and Stress Scale 21 (DASS-21). Moderate to severe symptoms of depression, anxiety, and stress were reported by 49.3%, 45.2%, and 54% of Arab students, respectively. Analyses indicate that low quality of online learning, academic difficulties, and negative economic effects of COVID-19 predicted stress, anxiety, and depression. Women reported higher levels of depression and stress; job loss predicted depression and anxiety; low income predicted depression; and COVID-19-related health concerns predicted anxiety. This study highlights the unique and multiple challenges faced by minority students from disadvantaged backgrounds. Campus programs are needed to address the emotional needs of students. Longitudinal research is needed to more fully understand the impact of COVID-19 on higher-education students.