The relationship between self-regulation, cognitive flexibility, and resilience among students: a structural equation modeling

BACKGROUND

Cognitive flexibility is an important construct that contributes to one's own thoughts, behaviors, and feelings to achieve his or her goals. Thus, it could play an essential role in students' educational achievements. This study aimed to investigate the mediating role of cognitive flexibility in the relationship between self-regulation and resilience among students.

METHOD

This was a cross-sectional study conducted on a sample of students during the 2022 and 2023 academic years. Students were selected from Tehran and Karaj universities (two metropolitans in central Iran). Data collection instruments included the Bouffard's Self-Regulation Scale, the Cognitive Flexibility Inventory (CFI), and the Connor-Davidson Resilience Scale (CD-RSC). Subsequently, the data were analyzed using structural equation modeling via SPSS and AMOS software to examine the relationships among variables.

RESULTS

In all 302 students participated in the study. The mean age of students was 25.8 (SD = 4.05) years. The findings indicated that self-regulation had a marked positive direct effect on cognitive flexibility (β = 0.23, p < 0.001), and resilience (β = 0.88, t = 19.50, p < 0.001). Similarly, cognitive flexibility displayed a strong positive influence on resilience (β = 0.1, p < 0.001) it showed an indirect mediating role between self-regulation and resilience (0.02), while resilience demonstrated a negative indirect effect on self-regulation and cognitive flexibility (-0.23). The goodness of fit indices validated the proposed model. Furthermore, the analysis revealed the significance of the final model's direct path coefficients, underscoring the mediating role of cognitive flexibility between self-regulation and resilience among students.

CONCLUSION

The findings indicated a pivotal interrelationship among self-regulation, cognitive flexibility, and resilience in students. The significant positive relationship among these constructs underscores the importance of fostering cognitive flexibility practices and self-regulation in educational settings.

Potential suicide risk among the college student population: machine learning approaches for identifying predictors and different students' risk profiles

BACKGROUND

Suicide is one of the leading causes of death among young people and university students. Research has identified numerous socio-demographic, relational, and clinical factors as potential predictors of suicide risk, and machine learning techniques have emerged as promising ways to improve risk assessment.

OBJECTIVE

This cross-sectional observational study aimed at identifying predictors and college student profiles associated with suicide risk through a machine learning approach.

METHODS

A total of 3102 students were surveyed regarding potential suicide risk, socio-demographic characteristics, academic career, and physical/mental health and well-being. The classification tree technique and the multiple correspondence analysis were applied to define students' profiles in terms of suicide risk and to detect the main predictors of such a risk.

RESULTS

Among the participating students, 7% showed high potential suicide risk and 3.8% had a history of suicide attempts. Psychological distress and use of alcohol/substance were prominent predictors of suicide risk contributing to define the profile of high risk of suicide: students with significant psychological distress, and with medium/high-risk use of alcohol and psychoactive substances. Conversely, low psychological distress and low-risk use of alcohol and substances, together with religious practice, represented the profile of students with low risk of suicide.

CONCLUSIONS

Machine learning techniques could hold promise for assessing suicide risk in college students, potentially leading to the development of more effective prevention programs. These programs should address both risk and protective factors and be tailored to students' needs and to the different categories of risk.

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

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

Parent strategies to help emerging adults manage stress are associated with their mental health: A dyadic coping perspective

Emerging adults (EAs) are at high risk for mental health challenges and frequently reach out to their parents for support. Yet little is known about how parents help emerging adults manage and cope with daily stressors and which strategies help and which hinder EA mental health. In this cross-sectional pilot study of students at a 2- and 4-year college (ages 18-25, N = 680, mean age = 19.0), we extend models of dyadic coping from intimate relationships to the parent-emerging adult relationship and test whether six specific parent strategies to help emerging adults manage stress are associated with EA mental health. Emerging adults with parents who provided problem and emotion-focused supportive dyadic coping, delegated dyadic coping, and common/joint dyadic coping reported fewer symptoms of anxiety and depression, as well as higher levels of psychological well-being. In contrast, college-attending emerging adults who reported higher levels of parent-provided negative dyadic coping reported higher levels of depressive and anxiety symptoms and lower psychological well-being. Parent-emerging adult dyadic coping is a fruitful area for future research and intervention development.

Preliminary evidence for the validity of the Brief Post-Secondary Student Stressors Index (Brief-PSSI): A cross-sectional psychometric assessment

The brief version of the Post-Secondary Student Stressors Index (Brief-PSSI) was developed in order to improve the usability of the instrument as a method for evaluating the severity and frequency of stressors faced by post-secondary students. While the original 46-item instrument has been thoroughly psychometrically validated and successfully used among student populations, the length of the instrument limits its utility. Providing a valid, shortened version of the PSSI will enable institutions to include the tool on existing online surveys currently being deployed to surveil the mental health and wellbeing of their students. This study reports preliminary evidence in support of the validity and reliability of the Brief-PSSI using a cross-sectional pilot sample of students attending an Ontario university in 2022. A total of 349 participants (average age 25 (SD = 7.7), range 19-60) completed the first survey, while 149 completed the follow-up survey (average age of 26 (SD = 7.7), range 17-60). Evidence of internal structure, relations to other variables, and of test-retest reliability was assessed according to established index validation guidelines, including the specification of multiple-indicator, multiple-cause models, and Spearman's rho correlation coefficients. Results provide preliminary support for the validity and reliability of the tool, which demonstrated acceptable goodness-of-fit statistics, statistically significant relationships with like constructs in the hypothesized directions, and good test-retest reliability correlation coefficients. The Brief-PSSI is a useful tool for evaluating the sources of stress among post-secondary students, assessing both the severity of stress experienced and frequency with which each stressor occurred. Future research should explore the practical utility of adding the Brief-PSSI to existing survey assessments as well as pursue the continued collection of validation evidence for the tool among varied student populations.

Personal growth Initiative as a protective factor between the relation of practical stress and life satisfaction

Objective: Stress stemming from practical or financial obstacles is among the top sources of stress for college students. The current study examined if one new positive psychological strength factor, personal growth initiative, functioned as a buffer to protect young adults' life satisfaction, anxiety, and depression from practical stress. Participants: Undergraduate students (N = 353, age range 18-23, 73.9% female) at a public university. Method: Participants were recruited through classes and on campus via flyers and completed self-report surveys online. Results: Personal growth initiative significantly moderated the relation between practical stressors and life satisfaction. Specifically, the negative effect of practical stressors on life satisfaction decreased as personal growth initiative levels increased. Practical stress significantly predicted anxiety and depression, though no significant interactions were identified in this model. Conclusion: Overall, results highlighted the protective function of personal growth initiative for life satisfaction in the context of practical stressors faced by young adults in college. Implications and future directions for research are discussed.

Effectiveness of an online mental health strengthening module to build resilience and overcome stress for transitional aged medical students

Introduction

Transitional-aged youths (17-to-24-years-old) are prone to mental-health problems. Students in higher education, especially medical students, are more exposed to stressors and thus need training to increase resilience. However, there have been limited mental-health strengthening modules specifically developed for medical students of transitional age, and none in Indonesia. This study intends to test the effectiveness of an online mental-health strengthening module in altering resilience.

Methods

A pragmatic randomized trial with repeated measurements was employed to evaluate biopsychosocial outcomes of resilience. The intervention module was delivered in 4 weeks to 105 eligible students. Participants were divided into intervention group (n = 52) and control group (n = 53). Outcomes were measured in the 4th, 8th, and 12th weeks. Primary outcome was resilience level as measured by Connor-Davidson Resilience Scale (CD-RISC). Perceived Stress Scale (PSS), Depression Anxiety Stress Scale (DASS) were utilized to measure stress, depression and anxiety. Knowledge and attitude toward mental-health were also measured through validated questionnaires. Stress levels of participants were measured biologically by measuring salivary cortisol and alpha-amylase levels at the baseline and 12th-week.

Results

Compared to the control group, there were no significant difference in resilience score of the intervention group compared to control group [F(1, 103) = 2.243, P = .137]; however, there was a significant main effect of time [F(3, 309) = 18.191, P < .001] and interaction effect between intervention and time in resilience score [F(3, 309) = 5.056, P = .002]. Additionally, compared to the control group, there were significant increases in knowledge [F(1, 103) = 66.805, P < .001], attitudes and behavior towards mental-health [F(1, 103) = 5.191, P = .025], and a significant decrease in stress perception score [F(1, 103) = 27.567, P < .001]. The mean salivary delta cortisol during pre-test and post-test at week 12 in the intervention group showed significant difference (P < .001). However, there was no significant difference in the mean delta salivary alpha-amylase between pre-test and post-test at week 12, both in the intervention and control groups.

Conclusion

The mental-health strengthening module was accepted and applicable to first-year medical students and was found to be effective in increasing resilience from various biopsychosocial aspects. It is also advisable to have similar modules throughout the medical school to maintain sustainability.

Stressors among young Australian university students: A qualitative study

OBJECTIVE

To explore stressors among young university students.

PARTICIPANTS

Twenty-nine 18- to 25-year-old university students.

METHOD

Four focus group discussions (n = 29) were conducted to explore mental health and stressors among domestic and international university students. Data was analyzed using thematic analysis to identify emerging themes and relationships.

RESULTS

Five primary stressors emerged from the data: Balance, Interpersonal Relationships, Future Prospects, Performance Pressure and Financial Issues and Employment. Although many distinct relationships were identified between themes, "Balance" affected and influenced most other stressors.

CONCLUSIONS

Five stressors were identified, most of which related to a lack of balance and time-management. Too many competing commitments and difficulty prioritizing were key influences. Interventions and policy to address stressors in students may reduce student psychological stress. Universities can provide support for students to prioritize commitments, provide flexible study opportunities and offer financial guidance.

Impact of COVID-19 Pandemic on Well-Being, Social Relationships and Academic Performance in a Sample of University Freshmen: A Propensity Score Match Evaluation Pre- and Post-Pandemic

The COVID-19 pandemic has impacted freshmen, compromising their mental health, lifestyles, and academic performance. There are few studies that have investigated changes in the health status and lifestyles of freshmen before and after the pandemic. The aims of this study were: (1) to carry out a pre-post-COVID-19 pandemic comparison between two freshmen samples, in order to detect differences in their socio-demographic characteristics and in some clinical variables; (2) to assess the effect of the COVID-19 pandemic on the social and academic lives of the second sample of freshmen. The samples recruited in 2019 and 2022, matched by propensity score procedure (N = 553), were mostly female (57.3% vs. 55.3%); the mean age was 22.9 and 20.9 years, respectively. The freshmen recruited after the pandemic had less psychological distress and substance use than freshmen recruited before the pandemic. Seventy-eight percent of the freshmen stated that the pandemic had an impact on their social relationships. This effect was greater for females and Italian students. Forty-seven percent reported that the pandemic has worsened their academic performance, while 60% stated that pandemic has improved their grades. The results of this study can provide valuable insights into the impact of the pandemic on freshmen, in order to implement interventions to mitigate the consequences of the pandemic in some subgroups of this target population.

The role of psychological distress, stigma and coping strategies on help-seeking intentions in a sample of Italian college students

BACKGROUND

Mental health issues are common among university students, but the latter are unlikely to seek professional help even when mental health services are available. Coping strategies, stigma and psychological distress are often considered as factors that can affect help-seeking intentions in university students.

METHODS

This study aimed to determine the role of coping strategies, stigma and psychological distress on the intentions to seek professional help for psychological problems. All students (N = 13,886) from an Italian medium-sized university were asked to participate in a multidimensional online survey and 3754 (27.1%) agreed to participate. A Structural Equation Modelling approach was applied to explore the simultaneous direct and indirect effects of distress, stigma and coping strategies on professional help-seeking intentions.

RESULTS

Results showed that students were not very likely to seek professional help and, through the Structural Equation Model, psychological distress was found to be positively correlated with coping strategies, which in turn was negatively associated with the stigma of seeking help. The latter was negatively associated with professional help-seeking intentions. These effects suggest that students with significant psychological distress use coping strategies to face the stigma of seeking help: the lower the stigma of seeking help, the higher the chance of developing intentions to seek professional help.

CONCLUSIONS

This study suggests the importance of implementing programs to encourage college students to seek help, including measures that foster a stigma-free environment, reduce psychological distress and promote the use of adaptive coping strategies. Interventions should be focused firstly on self-stigma and secondly on perceived stigma, taking into consideration the level of psychological distress and social stereotypes associated with mental disorders and help seeking behaviours. Programs about coping are also essential and should focus on promoting emotion-focused strategies and problem-focused strategies.

Correlates of self-harm in university students: A cross-sectional study

Objective: To determine the prevalence of university students who have ever engaged in self-harm and to examine its correlates. Frequency of thinking about self-harm was explored as a secondary outcome. Participants: Students at Western University in London, Ontario, Canada. Methods: This cross-sectional study was completed via an online questionnaire. Logistic regressions assessed the influence of sociodemographic and behavioral factors associated with lifetime self-harm and thoughts about self-harm. Results: The sample consisted of 2626 university students. Almost 25% engaged in self-harm in their lifetime and close to 33% have thought about harming themselves. A non-straight sexual orientation, marijuana use, prescription drugs not prescribed, and mental health problems increased the risk of both outcomes. Females were over two times more likely to engage in self-harm than males. Conclusion: This study provides evidence that is needed for developing effective interventions to reduce the risk of self-harm by targeting university students who are most at-risk.

Call for reimagining institutional support for PAR post-COVID

Although we believe academic researchers have a critical role to play in transformative systems change for social and ecological justice, we also argue that academic institutions have been (and continue to be) complicit in colonialism and in racialized, patriarchal capitalism. In this essay, we argue that if academia is to play a constructive role in supporting social and ecological resilience in the late stage Capitalocene epoch, we must move beyond mere critique to enact reimagined and decolonized forms of knowledge production, sovereignty, and structures for academic integrity. We use the pandemic as a moment of crisis to rethink what we are doing as PAR scholars and reflect on our experiences conducting PAR during the pandemic. A framework is presented for the reimaging of institutional support for the embedding of scholars in local social systems. We propose an academy with greater flexibility and consideration for PAR, one with increased funding support for community projects and community engagement offices, and a system that puts local communities first. This reimagining is followed by a set of our accounts of conducting PAR during the pandemic. Each account begins with an author's reflection on their experiences conducting PAR during the pandemic, focusing on how the current university system magnified the impacts of the pandemic. The author's reflection is then followed with a “what if” scenario were the university system changed in such a way that it mitigated or lessened the impacts of the pandemic on conducting PAR. Although this framework for a reimagined university is not a panacea, the reliance on strong in-place local teams, mutually benefiting research processes, and resources for community organizations putting in the time to collaborate with scholars can overcome many of the challenges presented by the pandemic and future crises.

Network analysis of psychological factors related to academic pressure faced by medical students in the central and highland regions of Vietnam

Medical students experience extensive pressure during their undergraduate courses. Given the complex associations between psychological factors in association with academic pressure. We investigated the study with objectives: To examine psychological factors related to academic pressure by analysing interactions between 'study motivation', 'study environment', 'study conditions', 'teacher quality', 'training programme', 'management system', 'evaluation', and 'extracurricular activities' using a network analysis approach. A total of 878 medical students majoring in general medicine from the first, third, and fifth years of a six-year course at the largest medical university in central and highland regions of Vietnam were involved in this cross-sectional study. The approach used was convenient cluster sampling with a self-administered questionnaire by the participants. Network analysis for pairwise correlations between psychological factors was estimated . Important factors in the network analysis were calculated using centrality indices including node strength (S), closeness (C), and betweenness (B). The higher score of S, C, and B indicate the more importance of the node. The results obtained from the network analysis of eight psychological factors showed that 'teaching quality' was mostly connected with other factors overall, while the 'training programme' was seen in both genders and freshman students. 'Study conditions' and 'training programme' were mostly connected with other factors in junior and senior students, respectively. The strong pairwise correlation was confirmed: management system and evaluation activity, followed by study environment and study conditions, and teaching quality and training programme. Additionally, nodes with high centrality were shown to be 'management system' (S = 0.97, C = 0.019, B = 1), and 'training programme' (S = 0.96, C = 0.021, B = 4). Our study findings indicate that satisfaction with the training programme amongst eight psychological factors is the most important factor affecting academic pressure among medical students. The training programme is linked with teaching quality, whereas the management system is correlated with evaluation activity.

Aerobic and Anaerobic Fitness according to High-Intensity Interval Training Frequency in Youth Soccer Players in the Last Stage of Rehabilitation

In the last stage of rehabilitation, high-intensity interval training (HIIT) for improving physical fitness is appropriate for return-to-play; however, some youth athletes visit the rehabilitation center less frequently due to conflict with their distance to center, and academic schedule. We tested the effects of short-term low-frequency HIIT in 54 youth male soccer players, after dividing them into a low-frequency group (LFG, n = 27 players) and a high-frequency group (HFG, n = 27 players). Muscle mass and body fat were measured using a body composition test, and VO₂peak and exercise duration were measured using a treadmill. Five sets of anaerobic peak power and fatigue were measured repeatedly using the Wingate test. To evaluate knee joint muscle function, 60°/s, 180°/s, and 240°/s were measured using the isokinetic muscle function equipment. HIIT sessions were conducted twice a week for LFG and five times a week for HFG for 4 weeks. In this study, Wilcoxon signed-rank test and Mann-Whitney U test were mainly used for analysis. Significant improvements in VO₂peak, anaerobic peak power, and knee strength were observed after intervention in both groups (p < 0.05). In the post test, there were significant differences between groups in VO₂peak (LFG, 56.4 vs. HFG, 57.1 mL/kg/min; p = 0.035), exercise duration (LFG, 972.3 vs. HFG, 990.4 s; p = 0.041), Wingate anaerobic peak power 5 sets (LFG, 606.3 vs. HFG, 629.3 Watt; p = 0.039), and muscle function test 240°/s (LFG, 68.5 vs. HFG, 70.2 Jouls; p = 0.010). However, neither group showed significant changes in body composition, such as muscle mass or body fat (p > 0.05). In conclusion, although it is a short-term training, the effect of HIIT was shown in the HFG as well as LFG. Although HFG improved physical fitness, significant improvement was also achieved in LFG. Therefore, in the last stage of rehabilitation, low frequency as well as high frequency HIIT would be an appropriate training method to improve physical fitness for youth soccer players.

A new, brief measure of college students' academic stressors

Objective: The purpose of this study was to evaluate the psychometric properties of a new measure of academic stressors (the ASM) in college students. Participants: The ASM was given to 677 undergraduate students at three universities along with measures of anxiety/depression, Big Five personality traits, and study skills. Methods: Tests of factorability and an exploratory factor analysis were completed. The internal and test-retest reliability of the measure was also evaluated. Results: The ASM is a concise, valid, and reliable tool for assessing college students' academic stressors. Conclusions: ASM scores predicted anxiety and depression symptoms. Therefore, the ASM can be used by colleges and university to assess students' levels of academic stressors to identify meaningful resources for support.

University students' profiles of burnout symptoms amid the COVID-19 pandemic in Germany and their relation to concurrent study behavior and experiences

Burnout symptoms are prevalent among university students. This study examined students' understudied profiles of burnout symptoms and their relation to procrastination, dropout intentions, and study- and life satisfaction. We used cross-sectional data from two online-studies conducted in Germany in April 2020 amid the COVID-19 pandemic (N _study1 = 597, N _study2 = 857). Latent profile analyses indicated three profiles in both studies: (1) well-functioning, (2) moderately exhausted-inefficacious, and (3) burned-out. Most students belonged to Profiles 1 and 2 with low to moderate burnout symptoms. Students in Profile 3 reported the highest symptoms, most procrastination, strongest dropout intentions, and lowest study- and life satisfaction. The distinct profiles broaden knowledge about intra-individual differences in students' burnout experiences and underpin the need for tailored interventions.

Development of the College Student Acute Stress Scale (CSASS)

PURPOSE

The purpose of this study is to develop and validate the College Student Acute Stress Scale, a measure of acute stress specific to college students.

DESIGN AND METHODS

A total sample of 440 young adults from a university in the northeast United States were surveyed across three separate research studies. Exploratory principal component analysis, internal consistency reliability, convergent and divergent validity, and test-retest reliability analyses were performed.

FINDINGS

Evidence of convergent and divergent validity were obtained, and adequate internal consistency and test-retest reliability were identified.

PRACTICE IMPLICATIONS

This study provides evidence for the validity and reliability of a self-report measure of college students' acute stress experiences.

Resilience to early family risk moderates stress-affect associations: A 14-day ecological momentary assessment study

BACKGROUND

Resilience in children with early family life adversity is linked with successful adulthood psychological outcomes. However, whether resilience influences daily emotional responses to stress remains unclear. This study examined whether resilience capacity in the context of early family risks predicts better daily stress and affect outcomes during a stressful transition.

METHODS

International and interstate undergraduates (N = 98; aged 18-25 years) were grouped as Resilient (high family risk, high resilience), Vulnerable (high family risk, low resilience), or Control (low family risk, average anxiety and depression). Daily negative (NA) and positive affect (PA), perceived stress, and stressors were assessed 4-times daily across 14 consecutive days (4333 total surveys; 73.7% completion rate). Affect reactivity was operationalized as the NA and PA slopes on perceived stress from each survey.

RESULTS

The Resilient group did not differ from the Control group on all outcomes. The Vulnerable group reported significantly higher number of stressors, perceived stress levels, NA, and NA reactivity than the Resilient and Control groups (all p < .001); as well as significantly lower PA (p = .024) and PA reactivity (p = .003) than the Control group.

LIMITATIONS

Our findings are not generalizable to other populations and cannot determine causality.

CONCLUSIONS

Our findings suggest that resilience capacity is protective against the effects of early family risks on a daily basis. However, significant findings were limited to emotional distress outcomes and not supported for PA, suggesting resilience capacity may attenuate emotional distress but not positive emotions in response to stress in emerging adults with family risk.

A qualitative inquiry comparing mindfulness-based art therapy versus neutral clay tasks as a proactive mental health solution for college students

Objective: College students experience unprecedented levels of stress and anxiety, impacting their desire to perform well and live a balanced life. Mindfulness-based practices along with art therapy techniques have been demonstrated to improve psychological and physiological impacts of stress and anxiety among college students. Participants: 12 undergraduate college students participated in pre and post-test interviews following their engagement in either mindfulness-based art therapy (MBAT) or a neutral clay task (NCT) using a 5-week online format. Methods: Descriptive phenomenology and artful inquiry were used to elicit participants' perspectives. Results: Both MBAT and NCT elicited relaxing and calming effects, but MBAT provided more proactive and direct benefits, with participants reporting that they could identify and move through stressors. While NCT participants described their experience as fun or playful. Conclusions: These findings offer notable support for implementing online and accessible mental health strategies such as MBAT and NCT into college settings.

Psychometric properties of the general self-efficacy scale among Thais with type 2 diabetes: a multicenter study

Background

Type 2 diabetes (T2D) is one of the most common chronic diseases in the world. In recent decades the prevalence of this disease has increased alarmingly in lower to middle income countries, where their resource-limited health care systems have struggled to meet this increased burden. Improving patient self-care by improving diabetes knowledge and diabetes management self-efficacy represents a feasible way of ameliorating the impact of T2D on the patient, and the health care system. Unfortunately, the relationships between self-efficacy, diabetes self-management, and thereafter, patient outcomes, are still far from well understood. Although a domain-specific measure of diabetes management self-efficacy, the Diabetes Management Self-Efficacy Scale (DMSES), has been validated in the Thai T2D population, more general measures of self-efficacy, such as the General Self-Efficacy scale (GSE) have not been validated in this population. In this paper we translate and examine the psychometric properties of the GSE in Thais living with T2D.

Methods

In this nation-wide study we examined the psychometric properties of the GSE in 749 Thais diagnosed with T2D within the last five years, and evaluated its relationship with the DMSES along with other patient characteristics. Reliability of GSE was assessed using Cronbach's alpha, and the construct validity was examined using confirmatory factor analysis, along with GSE's convergence and discrimination from DMSES.

Results

The Thai version of the GSE was shown to have good psychometric properties in Thais living with T2D. Cronbach's alpha was shown to be 0.87 (95% CI [0.86, 0.88]). We also demonstrated the structural validity of the GSE (Tucker-Lewis Index = 0.994, Cumulative Fit Index = 0.995, Adjusted Goodness of Fit Index = 0.998, Root Mean Square Error of Approximations = 0.025, 95% CI [0.06-0.039]), and that this instrument has a similar structure in Thais as in other populations. GSE was also shown to have some overlap with the DMSES with correlations among GSE and the DMSES domains ranging from 0.18 to 0.26, but also the GSE has substantial discrimination from DMSES (Disattenuated correlation coefficient = 0.283, 95% CI [0.214-0.352], p < 0.001). This suggests that while general and diabetes management self-efficacy are somewhat associated, there are aspects of diabetes management self-efficacy not captured by the more stable general self-efficacy.

Conclusions

We demonstrate that the Thai GSE is a reliable and valid measure. We believe the GSE may represent a useful tool to examine the efficacy of proposed and existing diabetes self-management, and management self-efficacy interventions.

Stress of university students before and after campus closure in response to COVID-19

Due to the COVID-19 pandemic, universities were forced to adopt a remote learning model, which introduced a number of stressors into college students' everyday life and study habits. The current study investigates if students' study-related stress increased after the pandemic's onset and how individual and contextual factors moderate this potential stress increase. Longitudinal survey data about students' stress levels and self-efficacy in self-regulation were collected before and after the onset of the COVID-19 pandemic at a public university (N = 274). Regression analysis results show an overall increase in study-related stress levels after the onset of the pandemic. Students with self-efficacy in self-regulation reported lower stress increases; students with higher mental health impairment and limited time for coursework reported larger stress increases. To address students' stress levels and strengthen coping resources, universities should consider providing students with resources to improve their self-regulation and time-management skills.

Associations of university student life challenges with mental health and self-rated health: A longitudinal study with 6 months follow-up

BACKGROUND

Mental health problems are highly prevalent among university students. Stress due to student life challenges may be a risk factor for poorer health. This study investigates to what extent student life challenges and changes therein are associated with mental health and self-rated health.

METHODS

In a longitudinal study with 568 Italian university students mental health was assessed using the Mental Health Inventory-5 (MHI-5) and self-rated health with a single item from the Short Form 36 Health Survey (SF36) (score ranges: 0-100) at baseline and at six months follow-up. Student life challenges were investigated using six subscales (score ranges: 1-4) of the Higher Education Stress Inventory (HESI). A between-within linear regression model was used to investigate whether a higher exposure to life challenges was associated with poorer health (between individuals) and whether changes in student life challenges were associated with changes in health (within individuals).

RESULTS

Higher exposure to student life challenges was associated with poorer mental health (b ranging from -5.3 to -10.3) and self-rated health (b ranging from -3.1 to -9.6). An increase in student life challenges within individuals was associated with poorer mental health and self-rated health, in particular for high workload (b up to -5.9), faculty shortcomings (b up to -5.7), and unsupportive climate (b up to -5.6).

DISCUSSION

Exposure to student life challenges and changes therein are associated with university students' health. Our findings suggest that student life challenges may be a target for interventions to improve mental health and self-rated health among university students.

Comparing National Collegiate Athletic Association Division II Athletes’ Perceptions of Social Support Following Injury, Illness, and Other Identified Stressors

Collegiate athletes have demonstrated a need for social support to help cope with their daily responsibilities. The purpose of this research was to explore National Collegiate Athletic Association Division II athletes’ perception of social support from friends, teammates, family, coaches, significant others, and athletic trainers following injury, illness, or other identified life stressors. There were 546 participants who completed a five-part survey using the University Stress Scale, the Multidimensional Scale of Perceived Social Support, the Athletic Multidimensional Scale of Perceived Social Support, the Perceived Stress Scale, and a demographic section. Of the participants, 352 (64.5%) stated that they experienced moderate stress levels, and all participants indicated experiencing an identified life stressor within the last 12 months. The results indicated statistically significant differences when comparing providers of social support: females preferred the support of friends, significant others, and athletic trainers, and freshmen and sophomores perceived more social support from friends than did juniors and seniors.

Wellbeing and nature connectedness for emerging adult undergraduates after a short expedition: A small pilot study

ISSUE ADDRESSED

Emerging adult university undergraduates are a vulnerable population due to various life stressors. Previous studies have reported a range of positive outcomes from outdoor expeditions for this population. This small pilot study aimed to investigate the impacts of an outdoor expedition on wellbeing and connectedness to nature and possible confounding by gender and living environment.

METHODS

A sample of 54 Health and Physical Education emerging adult undergraduates in the second year of their four-year degree completed a 3-day/2-night immersion expedition. Pre-post differences and a repeated-measures analysis with confounders examined the expedition's impact on scores from the Warwick-Edinburgh Mental Well-being Scale and Connectedness to Nature Scale.

RESULTS

Involvement in a short expedition resulted in improvements to wellbeing and connectedness to nature. Females reported a stronger connectedness to nature than males, while living environments may affect well-being. CONCLUSIONS/SO WHAT?: Incorporating regular contact with nature into the structure of undergraduate programs may improve wellbeing and protect this population's mental and emotional health. In a world adjusting to the effects of a global pandemic, opportunities for teaching in non-traditional classrooms (such as outdoors) may also protect physical health.

The Relationships Between Perceived Wellness, Sleep, and Acute: Chronic Training Load in National Collegiate Athletics Association Division I Male Soccer Players

ABSTRACT

Sekiguchi, Y, Curtis, RM, Huggins, RA, Benjamin, CL, Walker, AJ, Arent, SM, Adams, WM, Anderson, T, and Casa, DJ. The relationships between perceived wellness of, sleep of, and acute: chronic training load on National Collegiate Athletics Association division I male soccer players. J Strength Cond Res 35(5): 1326-1330, 2021-The purpose of this study was to investigate relationships between perceived wellness, sleep, and acute: chronic workload ratio (ACWR) throughout a collegiate men's soccer season. Sixty male collegiate soccer players (mean[M] ± SD; age, 21±2 year; body mass, 77.6 ± 6.5 kg; height, 180.1 ± 6.4 cm; body fat%, 9.9 ± 3.9% ; and V̇o2max, 53.1 ± 5.0 ml·kg-1·min-1) participated in this study. During each session, players used a heart rate and global positioning satellite-enabled chest strap to measure training impulse and ACWR. The ACWR values were trichotomized at the individual level giving an equal number of observations within each ACWR category of low, moderate, and high ACWR (M ± SD; low, 0.658 ± 0.23; moderate, 0.92 ± 0.15; and high, 1.17 ± 0.16). Stress, fatigue, and soreness levels were collected using 1-10 Likert scales and sleep duration, and sleep quality were measured by the Karolinska Sleep Diary. Stress, fatigue, soreness levels, and sleep quality were transformed to corresponding z-scores at the individual level. Fatigue levels were significantly higher when ACWR was high compared with low (mean difference [95% confidence intervals], effect size, p-value; 0.31 [0.21, 0.42], 0.29, p < 0.001) and moderate (0.14 [0.03, 0.24], 0.13, p = 0.01). Fatigue levels were also significantly higher when the ACWR was moderate compared with low (0.18 [0.07, 0.28], 0.16, p = 0.001). Soreness levels were significantly higher when the ACWR was high compared with low (0.25 [0.14, 0.36], 0.23, p < 0.001). Stress levels were significantly greater when the ACWR was high compared with low (0.19, [0.08, 0.29], 0.18, p < 0.001) and compared with moderate (0.15, [0.05, 0.25], 0.14, p = 0.004). There were no differences in sleep duration or sleep quality in different ACWR. The ACWR may be a useful tool to achieve an appropriate balance between training and recovery to manage daily fatigue and soreness levels in athletes.

Mental health among university students: The associations of effort-reward imbalance and overcommitment with psychological distress

BACKGROUND

Mental health problems are highly prevalent among university students, but little is known about their underlying determinants. This study explores mental health among university students, the association between "effort-reward imbalance" (ERI), overcommitment and mental health, and to what extent ERI and overcommitment explain gender differences in mental health.

METHODS

Cross-sectional data were analyzed from 4760 Italian university students. The Kessler Psychological Distress Scale-10 was used to measure self-reported psychological distress, as an indicator of mental health, and the ERI - Student Questionnaire to measure effort, reward and overcommitment. The associations between ERI and overcommitment with psychological distress were estimated with multinomial logistic regression analyses.

RESULTS

78.5% of the respondents experienced psychological distress, with 21.3%, 21.1%, and 36.1% reporting respectively mild, moderate and severe psychological distress. Female students were more likely to report moderate and severe psychological distress. ERI and overcommitment were strongly associated with severe psychological distress with ORs respectively up to 19.9 (95% CI: 12.2-32.5) and 22.2 (95% CI: 16.1-30.7). ERI and overcommitment explained part of the higher odds of severe psychological distress among female students comparing to males, attenuating the ORs from 2.3 (95% CI: 1.9-2.7) to 1.4 (95% CI: 1.2-1.7).

LIMITATIONS

This cross-sectional study was performed on a large, but convenient sample.

DISCUSSION

More than one out of three students reported severe psychological distress. Decreasing ERI and overcommitment may be beneficial in the prevention of psychological distress among university students and may reduce gender differences in psychological distress. Longitudinal studies are needed to further investigate these associations.

The Tridirectional Relationship among Physical Activity, Stress, and Academic Performance in University Students: A Systematic Review and Meta-Analysis

Higher education students often suffer from physiological and psychological health problems caused by stress, which may negatively impact their academic performance (AP). Physical activity (PA) can be a promising strategy to buffer these stress-induced complaints. Therefore, the aim of this investigation was to summarize evidence for the tridimensional construct of PA, stress, and AP, as well as to quantify the relationships among these variables. Five databases (PubMed, Scopus, SMEI, ERIC, and Web of Science) were systematically searched in November 2019 for publications that examined PA, stress, and AP of university students, without any restrictions regarding the publication period. The systematic review includes four original research studies with a moderate-to-high risk of bias. Results of included studies were narratively summarized and quantified in a meta-analysis using random effect models. Whereas study results point to a positive relation between PA and AP, relationships between PA and stress seem to be negative, while the relation between stress and AP is undecided. The meta-analysis found no significant associations and considerable heterogeneity of the results. Findings indicate a research gap concerning the connection of PA, stress, and AP in university students. Future studies should use validated measuring tools and consider the timepoint of data collection in order to extract truly stressful periods.

Stress among medical students: factor structure of the University Stress Scale among Italian students

OBJECTIVES

The main purpose of the current study was to investigate the psychometric properties of the Italian version of the University Stress Scale (USS) among Italian medical students.

DESIGN, SETTING AND PARTICIPANTS

A cross-sectional observational study based on data from an online cross-sectional survey from 11 to 23 December 2018. A total of 1858 Italian medical students participated in the study.

OUTCOME MEASURES

We measured perceived stress among medical students using the USS, the Effort-Reward Imbalance Student Questionnaire (ERI-SQ) and the Kessler-10 (K10).

RESULTS

Results showed that a bifactor-Exploratory Structural Equation Modeling solution provided excellent levels of fit to the data. Our results suggest that the modified version of 19 items of the Italian version of the USS does not have a simple unidimensional structure. Overall, an inspection of ancillary indices (omega indices, ECV and percentage of uncontaminated correlations) revealed that these were too low to suggest the use of the USS as a composite measure of university stress. We tested an alternative unidimensional short form (eight items; USS-S) that assessed all the five sources of stress. This version provided a good fit to the data. Evidence of convergent validity of the USS-S was observed by analysing the correlations between the USS and ERI-SQ (ranging from -0.34 to 0.37, all p<0.01). Finally, based on the clinical cut-off recommended on the K10, results from receiver operating characteristic showed that considering the clinical cut-off of the USS is 7.5 and that 59.70% of medical students reported stress levels in the clinical range.

CONCLUSION

Finally, our results showed a lack of support for using the USS to measure a general university stress factor, as the general USS factor accounted for little variance in our sample. In this sense, stress scores among Italian students can be better assessed by the use of the USS-S.

Depression and disclosure behavior via social media: A study of university students in China

Severe stress and depression constitute serious challenges to people in both personal and public health. Numerous university students suffer from depression each year while only fractions of them receive proper and competent treatments. Following the trends of the era, social media has been prevalent among university students and become a new platform to disclose depression references. The purpose of this study is to examine the effects of various stressors and the “Big Five” personality traits towards the intention of disclosing depression. Addition to the disclosure intention, this study also explores if respondents have presented their depression via social media profiles. Over 200 WeChat users were surveyed on their experiences from psychological stress factors under four categories - academy, relationship and practical issues.

Continued Influence of an English-as-an-Additional-Language Nursing Student Support Group

BACKGROUND

English-as-an-additional-language (EAL) nursing students are more likely to experience academic challenges than traditional nursing students whose primary language is English. To support EAL student success, a novel support group was established to address both the academic and nonacademic issues faced by these students.

METHOD

A hermeneutic approach was used to explore the perceived influence of a nursing student support group on EAL student success in a Canadian undergraduate nursing setting. Through individual interviews, a rich understanding of the lived experience of EAL nursing students was obtained.

RESULTS

The EAL Nursing Student Support Program provided a holistic approach to EAL student success, encompassing both academic and psychosocial support provisions embedded in discipline-specific curricula. Individual interviews regarding support group provisions revealed the perceived importance of balance, resiliency, helping others, culture, a safe place, social aspects, and group environment.

CONCLUSION

The continued success of this program necessitates the funding of this support group and other disciplinary support programs that provide comprehensive, discipline-specific approaches to EAL support, arguing against the centralized model of academic aid seen in many postsecondary institutions. [J Nurs Educ. 2019;58(11):647-652.].

Stress among university students: factorial structure and measurement invariance of the Italian version of the Effort-Reward Imbalance student questionnaire

Background

In the last decade academic stress and its mental health implications amongst university students has become a global topic. The use of valid and theoretically-grounded measures of academic stress in university settings is crucial. The aim of this study was to examine the factorial structure, reliability and measurement invariance of the short student version of the effort-reward imbalance questionnaire (ERI-SQ).

Methods

A total of 6448 Italian university students participated in an online cross-sectional survey. The factorial structure was investigated using exploratory factor analysis and confirmatory factor analysis. Finally, the measurement invariance of the ERI-SQ was investigated.

Results

Results from explorative and confirmatory factor analyses showed acceptable fits for the Italian version of the ERI-SQ. A modified version of 12 items showed the best fit to the data confirming the 3-factor model. Moreover, multigroup analyses showed metric invariance across gender and university course (health vs other courses).

Conclusions

In sum, our results suggest that the ERI-SQ is a valid, reliable and robust instrument for the measurement of stress among Italian university students.

Monitoring Training Loads and Perceived Stress in Young Elite University Athletes

With increased professionalism in sport there has been a greater interest in the scientific approach to training and recovery of athletes. Applying appropriate training loads along with adequate recovery, is essential in gaining maximal adaptation in athletes, while minimizing harm such as overreaching, overtraining, injury and illness. Although appropriate physical stress is essential, stress for many athletes may come from areas other than training. Stress from may arise from social or environmental pressure, and for many athletes who combine elite athletic training with university study, academic workloads create significant stress which adds to the constant pressure to perform athletically. This research aimed to determine if subjective stressors were associated with counterproductive training adaptations in university athletes. Moreover, it aimed to elucidate if, and when, such stressors are most harmful (i.e., certain times of the academic year or sports training season). We monitored subjective (mood state, energy levels, academic stress, sleep quality/quantity, muscle soreness, training load) and objective (injury and illness) markers in 182 young (18–22 years) elite athletes over a 4-year period using a commercially available software package. Athletes combined full-time university study with elite sport and training obligations. Results suggest athletes were relatively un-stressed with high levels of energy at the beginning of each university semester, however, energy levels deteriorated along with sleep parameters toward the examination periods of the year. A logistical regression indicated decreased levels of perceived mood (0.89, 0.85–0.94, Odds Ratio and 95% confidence limits), sleep duration (0.94, 0.91–0.97) and increased academic stress (0.91, 0.88–0.94) and energy levels (1.07, 1.01–1.14) were able to predict injury in these athletes. Examination periods coincided with the highest stress levels and increased likelihood of illness. Additionally, a sudden and high increase in training workload during the preseason was associated with an elevated incidence of injury and illness (r = 0.63). In conclusion, young elite athletes undertaking full-time university study alongside their training and competition loads were vulnerable to increased levels of stress at certain periods of the year (pre-season and examination time). Monitoring and understanding these stressors may assist coaches and support staff in managing overall stress in these athletes.

Measuring Burnout Among University Students: Factorial Validity, Invariance, and Latent Profiles of the Italian Version of the Maslach Burnout Inventory Student Survey (MBI-SS)

Burnout has a long tradition of studies in the workplace and recently researchers suggested burnout is also rising among university students. The Maslach Burnout Inventory (MBI) is considered a valid measure of burnout. However, the student version of the MBI (MBI-SS) has received limited empirical support. The aim of this paper is to analyze the factorial validity, invariance, and latent profiles of the Italian version of the MBI-SS in a sample university students. A total of 7757 Italian university students participated in an online cross-sectional survey. Results from explorative and confirmatory factor analyses showed acceptable fits for the Italian version of the MBI-SS. In addition, multigroup analyses supported full-metric invariance of MBI-SS within gender and academic level (bachelor vs. master). Finally, results from latent profile analysis showed that a three latent profile model was the better solution for the data: (a) burned-out (high levels of exhaustion, cynicism (CY), and low professional efficacy (PE); n = 2665, 34.2%); (b) overextended (high levels of exhaustion, moderate other, n = 3953, 51.0%); and (c) engaged (moderate exhaustion, low CY, and high PE, n = 1149, 14.8%). The resulting three-profile solution in the present study partially agrees with a prior study as it replicated three of the five-profile solution identified. In sum, we suggest that the MBI-SS is valid and reliable and represents a robust instrument for the measurement of burnout among Italian speaking university students.

Physical Activity and Academic Performance: The Mediating Effect of Self-Esteem and Depression

An important step to enhance the academic efficiency of students is increasing their physical activity. For this reason, it is necessary to see to what extent physical activity is related to the academic performance of the students and what might mediate this. A major objective of the study is to explore self-esteem and depression as mediators between physical activity and academic performance. On the basis of informed consent to participate in the study, 358 participants have been selected from Universities in Pakistan, and they were asked about their physical activity, depression during their study and self-esteem through self-report. Participants self-reported their self-esteem, level of depression and their physical activity through standardized measures; the Rosenberg Self-esteem scale (1965), the University stress scale (2016), and the short form of the International Physical Activity questionnaire (2003), respectively. Academic performance had been measured as the cumulative grade point average (CGPA) of the last two consecutive semesters. Self-esteem and depression were found to be significant mediators between physical activity and academic performance. The total effect of physical activity on academic performance was significant but smaller than the total indirect effect through mediators. Though total indirect effect is the combination of the effect of self-esteem and depression, but the larger contribution is of self-esteem which has been found to be the strongest mediator between physical activity and academic performance. The study has implications for future research, both in terms of testing the model and testing psychological constructs. Also, the study emphasizes that the importance of physical activity has to be kept in mind while designing a curriculum of an educational institution in order to foster sustainable development.