Intrinsic and extrinsic goals as moderators of stress and depressive symptoms in Chinese undergraduate students: A multi-wave longitudinal study

Digital measures of activity and motivation impact depression and anxiety in the real world

Mood and anxiety disorders are highly comorbid, with symptom severity varying over time. Individuals with and without these disorders completed 30-days of ecological momentary assessment (EMAs) of depression, anxiety and distress, developed based on the established Mood and Anxiety Symptom Questionnaire (MASQ). These electronic MASQ (eMASQ) EMAs were collected alongside novel intrinsic and extrinsic motivation EMAs, and physical/digital activity measures (steps/screentime) across N = 70-101 participants. Each eMASQ-EMA significantly related to its corresponding MASQ measure. Extrinsic and intrinsic motivation negatively related to each eMASQ-EMA and had the greatest influence on patients' overall symptom profile. Physical, but not digital activity, was negatively associated with concurrent and 1-week lagged anxiety and depression, highlighting the temporally delayed benefits of physical activity on depression and anxiety symptoms in psychiatric groups. Collectively, this study suggests cognitive constructs related to drive and physical activity, may be useful in predicting continuous and transient psychiatric symptoms in the real-world.

Death attitudes and good life experience: the mediation and suppression effects of intrinsic and extrinsic goals

This study employs Heidegger's philosophy, Goal Content Theory, and Terror Management Theory to investigate the roles of intrinsic and extrinsic goals in the relationship between death attitudes (neutral acceptance vs. death anxiety) and the good life experience. Analyzing nationally representative data from the Chinese Social Mentality Survey (N=10,195), structural equation models revealed three key findings: (1) Neutral acceptance positively correlated with the good life experience, whereas death anxiety demonstrated negative associations; (2) In the primary conceptual model (Model 1), intrinsic goals mediated while extrinsic goals suppressed the relationship between the death attitudes and the good life experience; (3) Further model validation indicated that consistent suppression effects of extrinsic goals in national stability (Model 2) and personal richness (Model 4) frameworks, with distinctive dual mediation emerging in family happiness (Model 3). Notably, the personal richness model (Model 4) showed non-significant total effects despite preserved mediation patterns. These results advance existential psychology by elucidating culture-specific mechanisms through which death attitudes influences well-being in Chinese populations, while providing empirical validation and theoretical refinement of Goal Content Theory's cross-cultural applicability.

Digital Mental Health Interventions for University Students With Mental Health Difficulties: A Systematic Review and Meta-Analysis

BACKGROUND

While third-level educational institutions have long provided counselling, a sharp rise in demand has led to limited access to mental health supports for many students, including those with ongoing difficulties. Digital mental health interventions represent one response to this unmet need, given the potential low cost and scalability associated with no-to-low human resources involved.

OBJECTIVE

The aim of this study was to conduct a systematic review and meta-analysis of the literature examining effectiveness of digital mental health interventions for university students with ongoing mental health difficulties.

METHODS

The following databases were searched: PubMed, EBSCOhost (CINHAHL/PsycINFO/PsycArticles) and Web of Science. Two-armed randomised-control trials were included in the meta-analysis. A random-effects meta-analysis was conducted and standardised mean differences were calculated. Effect sizes were then compared in terms of therapeutic approach, and whether interventions were fully automated or guided interventions. This study was registered with PROSPERO, CRD42024504265.

RESULTS

Thirty four eligible studies were included in this narrative synthesis, of which 21 randomised-controlled trials were included in the meta-analysis. Random-effects meta-analysis indicated an overall medium effect size in favour of digital interventions for both depression (Cohen's d = 0.55), and anxiety (Cohen's d = 0. 46). Of note, for anxiety outcomes, fully automated interventions appeared more effective (d = 0.55) than guided interventions (d = 0.35).

CONCLUSIONS

Digital mental health interventions are associated with beneficial effects for college students when measured in terms of anxiety and depression symptom severity. For anxiety, fully automated interventions may be more effective than guided interventions to reduce symptom severity.

Developmental Trajectories of Intrinsic and Extrinsic Goals From Early to Late Adolescence and the Association with Internalizing and Externalizing Problems

Although numerous studies have explored the causes and consequences of intrinsic and extrinsic life goals, the developmental trend of life goals during adolescence has not been well understood. To address this research gap, this study explored the developmental changes of the pursuit of intrinsic and extrinsic goals during early, middle, and late adolescence, and examined the relation between life goals and internalizing/externalizing problems from a developmental perspective. A total of 4703 Chinese adolescents from primary (N = 1819, 47.8% girls, Mage T1 = 9.34, SDage T1 = 0.58), middle (N = 1525, 47.5% girls, Mage T1 = 12.47, SDage T1 = 0.59), and high school (N = 1646, 51.9% girls, Mage T1 = 15.45, SDage T1 = 0.65) participated in this two-year, three-wave longitudinal study. The results revealed that the pursuit of intrinsic goals increased among primary school students, but decreased among middle and high school students. Conversely, the pursuit of extrinsic goals exhibited a consistent increase among adolescents in primary, middle, and high school. Girls have higher initial levels of intrinsic goals than boys in primary school, and boys' intrinsic goals declined faster than girls' in middle school. Additionally, the initial level and developmental rate of intrinsic goals among three developmental stages were significantly associated with internalizing/externalizing problems, with lower initial level, slower growth rate, and faster decline rate being associated with more internalizing and externalizing problems. The significant association between the initial level and developmental rate of extrinsic goals and internalizing/externalizing problems were mainly observed among late adolescents, with higher initial level and growth rate being associated with more internalizing and externalizing problems. These findings delineate the differences in developmental trends between intrinsic and extrinsic goals, underscore the robust relation between intrinsic goals and internalizing/externalizing problems, and figure out the development-stage differences in the relation between extrinsic goals and internalizing/externalizing problems.

How occupational physicians pay attention to the values of employees: a qualitative study

PURPOSE

The Dutch Association for Occupational Medicine considers employee values to be an essential pillar in occupational medicine. The occupational physician should focus on what an employee finds valuable. However, it is unclear how occupational physicians comply with this policy and pay attention to employee values. The present study aims to fill this gap by mapping to what extent occupational physicians pay attention to employee values.

METHOD

We used an exploratory qualitative research method through in-depth interviews with 10 Dutch occupational physicians. Additionally, two non-participating observations were conducted.

RESULTS & CONCLUSION

The results show that values remain mostly implicit and are applied intuitively or unconsciously but not explicitly. Hence, the ethical requirements of the Dutch Association for Occupational Medicine policy remain underexposed and under-executed. Multiple facets foster or impede a conversation about values. As far values were mentioned they were mainly extrinsic, social, and prestige-oriented. Intrinsic values were hardly mentioned. However, a few occupational physicians explicitly stated that they pay attention to values and reported that heeding to employee values contributes to better collaboration and decision-making with the employee. We argue that paying attention to intrinsic values may improve the overall work quality of occupational physicians and benefit employee well-being.

Relationships between depression, anxiety, and motivation in the real-world: Effects of physical activity and screentime

Background

Mood and anxiety disorders are highly prevalent and comorbid worldwide, with variability in symptom severity that fluctuates over time. Digital phenotyping, a growing field that aims to characterize clinical, cognitive and behavioral features via personal digital devices, enables continuous quantification of symptom severity in the real world, and in real-time.

Methods

In this study, N=114 individuals with a mood or anxiety disorder (MA) or healthy controls (HC) were enrolled and completed 30-days of ecological momentary assessments (EMA) of symptom severity. Novel real-world measures of anxiety, distress and depression were developed based on the established Mood and Anxiety Symptom Questionnaire (MASQ). The full MASQ was also completed in the laboratory (in-lab). Additional EMA measures related to extrinsic and intrinsic motivation, and passive activity data were also collected over the same 30-days. Mixed-effects models adjusting for time and individual tested the association between real-world symptom severity EMA and the corresponding full MASQ sub-scores. A graph theory neural network model (DEPNA) was applied to all data to estimate symptom interactions.

Results

There was overall good adherence over 30-days (MA=69.5%, HC=71.2% completion), with no group difference (t(58)=0.874, p=0.386). Real-world measures of anxiety/distress/depression were associated with their corresponding MASQ measure within the MA group (t's > 2.33, p's < 0.024). Physical activity (steps) was negatively associated with real-world distress and depression (IRRs > 0.93, p's ≤ 0.05). Both intrinsic and extrinsic motivation were negatively associated with real-world distress/depression (IRR's > 0.82, p's < 0.001). DEPNA revealed that both extrinsic and intrinsic motivation significantly influenced other symptom severity measures to a greater extent in the MA group compared to the HC group (extrinsic/intrinsic motivation: t(46) = 2.62, p < 0.02, q FDR < 0.05, Cohen's d = 0.76; t(46) = 2.69, p < 0.01, q FDR < 0.05, Cohen's d = 0.78 respectively), and that intrinsic motivation significantly influenced steps (t(46) = 3.24, p < 0.003, q FDR < 0.05, Cohen's d = 0.94).

Conclusions

Novel real-world measures of anxiety, distress and depression significantly related to their corresponding established in-lab measures of these symptom domains in individuals with mood and anxiety disorders. Novel, exploratory measures of extrinsic and intrinsic motivation also significantly related to real-world mood and anxiety symptoms and had the greatest influencing degree on patients' overall symptom profile. This suggests that measures of cognitive constructs related to drive and activity may be useful in characterizing phenotypes in the real-world.

Collective action mitigates the negative effects of COVID-19 threat and anti-abortion restrictions on mental health

BACKGROUND

The COVID-19 pandemic changed our lives in many different domains, forcing people to adapt to countrywide lockdowns, school shutdowns, and business closures. The burden of the COVID-19 pandemic resulted also in deterioration of mental health. At the same time, political conflicts and social inequalities was reinforced and many people engaged in demonstrations to fight for their rights. This study examines whether collective acting for an important cause during the pandemic might mitigate the impact of both political tension related to anti-abortion restrictions and COVID-19 threats on mental health.

METHODS

We conducted a two-wave study with a representative sample of the Polish population, investigating the effect of participating in Polish pro-choice demonstrations on depressive and anxiety symptoms.

RESULTS

Participating in protests attenuated the negative effects of COVID-19 threat and anti-abortion restrictions on mental health. Moreover, we found that the feeling of solidarity with other demonstrators and sense of agency derived from such demonstrations led to lower levels of depressive and anxiety symptoms.

CONCLUSION

The results of the study indicate that participating in meaningful and value-oriented collective action may serve as a buffer against the detrimental effects of social and health threats.

How Do Late Adults Experience Meaning During the COVID-19 Lockdown? The Role of Intrinsic Goals

Late adults differ in the degree to which their mental health is impacted by the COVID-19 crisis, with interindividual differences in their capacity to mobilize coping resources playing an important role. Therefore, the search for inner sources of resilience is important to understand late adults' adaptation to this crisis. Based on Goal Content Theory, a mini-theory within the broader Self-Determination Theory, this study aimed to examine whether older adults' valuation and attainment of intrinsic goals represent such a source of resilience. Intrinsic goals would form a solid foundation to experience a sense of meaning during this crisis, which, in turn, relates to higher well-being (i.e., life satisfaction and vitality) and lower ill-being (i.e., symptoms of depression, anxiety, and loneliness). During the second month of the lockdown period in Belgium, 693 older adults (Mage = 70.06, SD = 4.48, range: 65-89 years, 62.1% female) filled out online questionnaires concerning the study variables. Structural equation modeling showed that intrinsic goal attainment and goal importance related positively to experiences of meaning in life which, in turn, were related to higher levels of well-being and lower levels of ill-being. No evidence was found for an interaction effect between intrinsic goal attainment and goal importance. Supporting late adults' pursuit and attainment of meaningful intrinsic goals relates to their well-being and may potentially strengthen their resilience in times of crisis.

Depression and workaholism in undergraduates: Examining gender as a moderator

Introduction: This study aims to examine the association between depression and workaholism among university students. Methods: Participants were 182 undergraduates at a large university in the South of Poland, aged between 20-28 years old (M = 22.17, SD = 1.39), including 102 women (56%). The cross-sectional study used the Beck Depression Inventory (BDI) and the Work Addiction Risk Test (WART). Results: This study shows that depression and workaholism levels are significantly lower in Physical Education students than other faculties' students. Gender moderates the relationship between workaholism and depression. Women demonstrate a stronger association between depression and workaholism than men. Conclusions: Both physical activity and gender appear to play an essential role in mental health prevention. The result of this study should be considered in therapy and prevention programs at university campuses.

The Mediating Role of Stress Perception in Pathways Linking Achievement Goal Orientation and Depression in Chinese Medical Students

Mental health problems are frequent obstacles in medical students’ careers as doctors. Given that previous studies overlook the mediation of stress perception, the current study expanded previous goal orientation researches by addressing an unexplored mechanism. This study aims to examine the mediational roles of stress perception (perceived stressors and stress-related cognition) on the relationship between achievement goal orientation and depression in medical students. A total of 1,015 Chinese 2-year medical students completed a multi-section questionnaire. Hypotheses were examined by structural equation modeling. The findings suggest that performance-avoidance goal orientation and perceived stressors both demonstrated direct facilitative effects on depression, whereas stress-related cognition demonstrated direct obstructive effects on depression. Both perceived stressors and stress-related cognition mediated the relationship between achievement goal orientation and depression. The findings spark a new perspective on motivational intervention that assist students in adopting mastery-approaching strategy as well as ways of coping with stressful academic situations. Identifying students with achievement goal orientation and providing them with the appropriate supportive services may help them to manage stress and mitigate or prevent depression.

Motivational orientation mediates the association between depression and cardiovascular reactivity to acute psychological stress

Recent theoretical developments in cardiovascular reactivity research suggest the association between depression and blunted reactions to stress is linked to motivational factors. Thus, the present study aimed to test whether the association between depressive symptoms and cardiovascular reactivity to acute stress was mediated by motivation; be it intrinsic or extrinsic motivation. One hundred and eighty-two healthy young adults completed measures of motivation (Global Motivation Scale; GMS), and depression (Hospital Anxiety and Depression Scale; HADS) and had their blood pressure and heart rate monitored throughout a standardised stress testing protocol. Results indicated that depression was negatively associated with both systolic blood pressure (SBP) and heart rate (HR) reactions to the stress task (all ps < .05), such that those who reported higher depressive symptomology displayed a blunted response. Furthermore this relationship was mediated by intrinsic, but not extrinsic motivation; the blunted responses were less pronounced through intrinsic motivation. The present findings add extensively to existing research and confirm that motivation is an underlying mechanism linking depression and cardiovascular reactivity.

Association of self-reported religiosity with the development of major depression in multireligious country Japan

AIM

In Western Christian countries, religiosity is generally believed to be associated with a lower risk for depression, which is supported by epidemiological evidence. However, the association between religiosity and depression in multireligious countries is unknown. The objective was to evaluate the association between religiosity and subsequent depression in a multireligious population.

METHODS

A longitudinal study was conducted in a large hospital in Tokyo, Japan, from 2005 to 2018. All participants who underwent health check-ups without a prior history of depression or depression at baseline were included. Our outcome was development of major depressive disorder (MDD), which was compared according to the degree of religiosity, adjusting for potential confounders.

RESULTS

Among 67 723 adult participants, those who were more religious tended to be older, female, married, and to have healthier habits but also more medical comorbidities at baseline. During a median follow-up of 2528 days, 1911 (2.8%) participants developed MDD. Compared to the reference group, religious group participants tended to have higher odds ratios (OR) for developing MDD in a dose-dependent manner. Among them, the extremely religious group (OR, 1.51; 95% confidence interval [CI], 1.28-1.78) and the moderately religious group (OR, 1.30; 95% CI, 1.14-1.49) were statistically associated with increased development of MDD compared to the not-religious-at-all group. Those who had increased their religiosity from baseline had statistically lower development of MDD (OR, 0.85; 95% CI, 0.75-0.97) compared to those who remained in the same degree of religiosity from baseline.

CONCLUSION

Religiosity was associated with future MDD in a dose-dependent manner in a multireligious population, which was in the opposite direction from that seen in previous Western longitudinal studies.

Motivation, health-related lifestyles and depression among university students: A longitudinal analysis

Positive motivational attitudes protect against depressive symptoms in young adults. This study examined the longitudinal relationship between motivation to achieve important life goals and depression in a sample of young adult university students, who are at higher risk of developing psychiatric disorders and adopting unhealthy behaviours than their age peers who are not attending university. The participants were 228 Italian undergraduates who completed an online self-report questionnaire twice during a one-year period. Measures included positive motivational attitudes, depressive feelings, body mass index, smoking, alcohol consumption, cannabis use, subjective family income and satisfaction with academic choice. A cross-lagged longitudinal model demonstrated that higher motivation predicted lower depression after one year. No other covariate effects were observed. The results confirm that motivation protects against mental health problems during higher education and is a better predictor of mental health than health-related risk factors. Encouraging undergraduates to invest effort in achieving important goals may prevent the onset of depressive disorders.

Gender differences in factors associated with smartphone addiction: a cross-sectional study among medical college students

BACKGROUND

Smartphones are becoming increasingly indispensable in everyday life for most undergraduates in China, and this has been associated with problematic use or addiction. The aim of the current study was to investigate the prevalence of smartphone addiction and the associated factors in male and female undergraduates.

METHODS

This cross-sectional study was conducted in 2016 and included 1441 undergraduate students at Wannan Medical College, China. The Smartphone Addiction Scale short version (SAS-SV) was used to assess smartphone addiction among the students, using accepted cut-offs. Participants' demographic, smartphone usage, and psycho-behavioral data were collected. Multivariate logistic regression models were used to seek associations between smartphone addiction and independent variables among the males and females, separately.

RESULTS

The prevalence of smartphone addiction among participants was 29.8% (30.3% in males and 29.3% in females). Factors associated with smartphone addiction in male students were use of game apps, anxiety, and poor sleep quality. Significant factors for female undergraduates were use of multimedia applications, use of social networking services, depression, anxiety, and poor sleep quality.

CONCLUSIONS

Smartphone addiction was common among the medical college students investigated. This study identified associations between smartphone usage, psycho-behavioral factors, and smartphone addiction, and the associations differed between males and females. These results suggest the need for interventions to reduce smartphone addiction among undergraduate students.