Post-traumatic stress disorders, anxiety, and depression in college students during the COVID-19 pandemic: a cross-sectional study

No particularly negative impact of the Covid-19 pandemic on the mental health of individuals with higher levels of childhood trauma

Background

Initial studies suggest that individuals with a history of traumatic life experiences, particularly childhood trauma, may be more susceptible to increased mental health problems in the wake of the COVID-19 pandemic.

Methods

The present cross-sectional study compared the mental health status of three cohorts of university students before (2016), at the beginning (2020) and at the end (2022) of the COVID-19 pandemic. The students in each cohort were divided into two groups: those with self-reported moderate/severe childhood trauma (n = 126) and those with no/mild childhood trauma (n = 438).

Results

Across all cohorts, students with moderate/severe childhood trauma consistently reported higher levels of psychological and physical stress compared to individuals with no/mild childhood trauma experiences. However, only the no/mild childhood trauma group exhibited an increase in mental health problems (i.e., heightened depressive symptoms and greater subjective impairment due to physical and psychological symptoms) during the COVID-19 pandemic. Furthermore, within the no/mild childhood trauma group, students in the 2022 cohort reported significantly higher psychological distress compared to those surveyed in 2020. In contrast, mental health scores among students with moderate/severe childhood trauma remained unchanged across the pre-pandemic and pandemic cohorts.

Conclusions

The findings of this study do not support the hypothesis that the COVID-19 pandemic disproportionately exacerbated mental health problems in individuals with a history of moderate to severe childhood trauma. Instead, our results suggest that the pandemic's impact on mental health was more pronounced in students with no or only mild childhood trauma.

Association of health locus of control with anxiety and depression and mediating roles of health risk behaviors among college students

We aimed to assess the association of health locus of control with anxiety and depression, and explore the mediating effects of health risk behaviors. A multi-stage cluster random sampling method was used among Chinese college students. Logistic regression models were used to explore the associations of health locus of control with anxiety and depression. Structural equation models were used to explore the mediation roles of health risk behaviors in the associations of health locus of control with anxiety and depression. A total of 3,951 college students were included in this study. Internality was associated with lower prevalence of depression (OR = 0.94, 95% CI, 0.91-0.97), powerful others externality was also associated with lower prevalence of anxiety and depression (0.92, 0.88-0.96; 0.93, 0.89-0.96), while chance externality was associated with higher risk of anxiety and depression (1.13, 1.08-1.18; 1.24, 1.20-1.28). The mediated proportion of health risk behaviors in associations of internality, powerful others externality, chance externality with anxiety was 7.55%, 2.37% and 2.18%, respectively. The mediated proportion of health risk behaviors in associations of powerful others externality, chance externality with depression was 10.48% and 2.14%, respectively. Health locus of control is associated with anxiety and depression that are mediated by health risk behaviors.

Associations between takeaway food consumption, physical activity levels, and their joint effect with comorbid depression and anxiety symptoms among Chinese university students

BACKGROUND

The prevalence of depression and anxiety symptoms, and their comorbid among Chinese university students is rising. Psychological symptoms are strongly associated with lifestyle choices, such as takeaway food consumption and physical activity. While the association between takeaway food consumption, physical activity level, and their joint effect on the psychological symptoms of university students are still unclear. In this study, we explore the associations between them.

METHODS

Using stratified cluster sampling, 14,340 students aged 18-22 from four provinces in China were selected as participants. A self-survey takeaway food consumption behavior questionnaire; the International Physical Activity Questionnaire Chinese Short Form; and the Depression, Anxiety, and Stress Scales-21 Short Version were used in this survey. Chi-square tests and binary logistic regression analyses were used to analyze the association.

RESULTS

The incidence rates of depression symptoms, anxiety symptoms, and CDAS were 26.26%, 34.58%, and 23.75%, respectively. Higher takeaway food consumption was positively associated with CDAS rates. Furthermore, compared with female students, the CDAS rates of male students were more likely to be influenced by different takeaway food consumption and physical activity. As for joint effect of takeaway food consumption and physical activity, overall, participants who engaged in light physical activity had a higher risk of CDAS with the increase in takeaway food consumption (OR = 1.279-2.661, 95% CI = 1.119-3.194, all p < 0.001). Moreover, participants with combination of moderate or vigorous physical activity and frequent takeaway food consumption (4-6 or ≥ 7 times/week) were more likely to suffer from CDAS (moderate: 4-6 times/week OR = 1.568, 95% CI: 1.206-2.039; ≥7 times/weeks: OR = 1.802, 95% CI: 1.202-2.700; vigorous: 4-6 times/week OR = 2.075, 95% CI: 1.623-2.653; ≥7 times/weeks: OR = 2.272, 95% CI: 1.567-3.295; all p < 0.05). In general, light to moderate physical activity levels and higher frequency of takeaway food consumption were associated with a higher risk of CDAS in male students than in female students.

CONCLUSION

High consumption of takeaway food and lower physical activity levels may be risk factors for depression and anxiety in university students. In general, the psychological symptoms of male students are more likely to be influenced by these factors than those of female students.

Managing Circadian Rhythms: A Key to Enhancing Mental Health in College Students

OBJECTIVE

To investigate the impact of circadian rhythm disruptions on mental health among college students and explore effective interventions for maintaining stable circadian rhythms.

METHODS

A comprehensive review of literature was conducted, focusing on sleep patterns, circadian rhythms, and their effects on mental health. Studies were analyzed to identify common factors contributing to circadian misalignment in college students and effective treatments. Data from large-scale studies and specific clinical trials were utilized to understand the relationship between circadian rhythms and psychiatric disorders.

RESULTS

Disruptions in circadian rhythms were linked to increased prevalence of psychiatric disorders such as depression, anxiety, and bipolar disorder. Biological changes during adolescence, academic pressures, and extensive use of electronic devices were major contributing factors. Effective interventions included light therapy, chronotherapy, melatonin supplementation, and cognitive behavioral therapy for insomnia.

CONCLUSION

Stable circadian rhythms are crucial for mental health, particularly in college students who are vulnerable to disruptions due to lifestyle factors. Implementing interventions such as regular sleep schedules, light exposure management, and behavioral therapies can significantly improve mental health outcomes. Further research and targeted mental health programs are essential to address circadian misalignment and its associated psychiatric disorders in this population.

The Development and Preliminary Validity and Reliability of Self-Disclosure to Romantic Partner (SDRP) Scale

The purpose of the present study was to develop and conduct a preliminary psychometric evaluation of the Self Disclosure to Romantic Partner Scale that assesses adults' attitudes towards sharing their personal information that includes disturbing feelings, thoughts, and experiences with their romantic partners. Two studies were conducted for this purpose. The first study was carried out with 200 participants and the second study was conducted with 206 participants. Exploratory factor analysis and confirmatory factor analysis showed a one-dimensional factor structure for the seven items of the Self Disclosure to Romantic Partner Scale. Furthermore, the results indicated that Cronbach alpha and McDonald's omega coefficient of Self Disclosure to Romantic Partner Scale were over .70 for both studies. Taken together, these findings suggest that Self Disclosure to Romantic Partner Scale has good psychometric properties.

Mental health issues of higher education students reflected in academic research: A text mining study

Objective: This study investigated mental health issues among higher education students to identify key concepts, topics, and trends over three periods of time: Period 1 (2000-2009), Period 2 (2010-2019), and Period 3 (2020-May 2024). Methods: The study collected 11,732 bibliographic records from Scopus and Web of Science, published between January 2000 and May 2024, and employed textual analysis methods, including keyword co-occurrence analysis, cluster analysis, and topic modeling. Results: In Period 1, general topics related to mental health disorders and treatments were identified. Period 2 showed prominence of well-being and help-seeking, as well as the emergence of digital mental health. Period 3 emphasized the impact of COVID-19 and increased technology usage. Conclusions: Based on the findings, we discussed the significance of the study and practical implications for clinicians and policymakers, as well as methodological implications for researchers. Additionally, the limitations of the study and future research were addressed.

Depression and Smartphone Addiction Among College Students: The Mediating Effect of Emotional Exhaustion

Objective

Multiple studies claim that depression was a triggering factor for smartphone addiction among college students. But we still know very little about the underlying mechanisms of smartphone addiction. The aim was to shed light on the underlying mechanisms of smartphone addiction from the perspective of depression and emotional exhaustion, to provide alternative paths for university administrators to address smartphone addiction among college students.

Methods

A total of 2764 Chinese college students participated in the survey. They independently filled out self-assessment questionnaires including the Cell Phone Addiction Scale, Beck Depression Inventory II, and Emotional Exhaustion Scale. Subsequently, mediation analysis was conducted using the PROCESS macro developed by Hayes (v 4.0; Model 4).

Results

Statistical analysis showed that depression was positively correlated with emotional exhaustion and smartphone addiction, emotional exhaustion was positively correlated with smartphone addiction, all of which were statistically significant. In addition, the effect of depression on smartphone addiction among college students was partially mediated by emotional exhaustion.

Conclusion

The impact of depression and emotional exhaustion on smartphone addiction had been preliminarily explored, which had certain value for further understanding of smartphone addiction among college students. This study could provide references for universities to develop intervention measures for smartphone addiction.

Effect of three modalities on emergence agitation among post-traumatic stress disorder patients undergoing laparoscopy: a randomized controlled study

BACKGROUND AND AIM

Emergence agitation (EA) after general anesthesia is common in patients with post-traumatic stress disorder (PTSD). Due to the recent worldwide events such as the Covid-19 pandemic and wars, PTSD is not rare. Accordingly, a reliable, cost-effective anesthetic protocol to lower the incidence of EA is crucial. Therefore, we aimed to compare three different interventions for avoiding EA in PTSD patients undergoing gynecological laparoscopic surgery. Participants were divided into four groups: 1: performing pre-operative relaxation techniques (deep breathing exercise and progressive muscle relaxation [PMR]); 2: administrating intra-operative Ketamine; 3: applying both previously mentioned strategies and 4 as controls.

METHODS

This study was carried out on 144 adult women scheduled for gynecological laparoscopy, randomly allocated into four groups: three intervention groups and a control group (36 each). Women aged 18-45 years old, with a diagnosis of PTSD were included in the study. Patients with a positive history of major neurological, cardiovascular, metabolic, respiratory, or renal disease were excluded. Any patient who reported the use of psychiatric drugs were also excluded from the study. Data was analyzed using IBM SPSS Statistics software version 26. Kolmogorov- Smirnov was used to verify the normality of the distribution of variables. Odds ratio was calculated to clarify the strength and direction of the association between intervention groups and control. Data was deemed significant at a p-value ≤0.05.

RESULTS

Heart rate (HR) and Mean Arterial Blood Pressure (MABP) intra-operative and post-operative till 24 hours were significantly lower in groups 1, 2, and 3 compared to group 4 (p<0.001). There was a significant statistical difference in the intraoperative HR percentage decrease. MABP percentage decrease post-operative was higher in all the intervention groups with no statistically significant difference, except for group 1 compared to group 4, which was statistically significant (12.28 ± 11.77 and 6.10 ± 7.24, p=0.025). Visual Analogue Scale measurements were significantly less in the intervention groups 1, 2, and 3 compared to group 4. On Riker sedation-agitation scores, group 1 was 85 times more likely to be non-agitated (85 (15.938 - 453.307), p<0.001), group 2 was 175 times more likely to be non-agitated (175 (19.932-1536.448), p<0.001) and group 3 was protected against agitation.

CONCLUSION

Pre-operative relaxation techniques (breathing exercises and PMR) significantly lowered HR, MABP, VAS score, and EA than controls. These effects were not significantly different from intra-operative ketamine injection or the combination of both (relaxation techniques and ketamine). We recommend routine pre-operative screening for PTSD and the application of relaxation techniques (breathing exercises and PMR) in the pre-operative preparation protocol of PTSD-positive cases as well as routine practical application of preoperative relaxation techniques. Further studies on using pre-operative relaxation techniques in general could be cost-effective.

Socio-economic factors associated with post-traumatic stress symptoms among adolescents and young people during the first wave of the COVID-19 pandemic

This study assessed the association between sociodemographic factors and post-traumatic stress symptoms (PTSS) among 18-24-year-olds during the first wave of the COVID-19 pandemic. This was a secondary analysis of data from 4508 individuals collected through an online survey conducted between June and January 2021. PTSS was measured as a dependent variable using the checklist for post-traumatic stress disorder in civilians. Age, birth sex, sexual, level of education, access to emotional and social support, and emotional distress were the independent variables. A multivariate logistic regression analysis was conducted to determine the associations between the dependent and independent variables while controlling for the country related confounding variables. Females (AOR:2.023), sexual minority individuals (AOR:1.868), those who did not disclose their sexual identify (AOR:1.476), those with poor access to emotional and social support (AOR:4.699) and individuals with no formal education (AOR:13.908), and only primary level education (AOR:4.521) had higher odds of PTSS. The study highlights the multifaceted nature of PTSS during the pandemic and suggests the importance of promoting access of young people, especially females, sexual minority individuals and those with low educational status, to emotional/social support to mitigate the probability of PTSS, especially among sexual minority individuals.

Trait rumination in post-stress growth among Chinese college students: the chain mediating effect of distress disclosure and perceived social support

Background

Rumination has emerged as a significant factor contributing to personal growth following periods of stress or trauma. The present study aimed to investigate the relationship between trait rumination and post-stress growth (PSG) within the context of Chinese college students who encounter mild stressors in their daily lives. Moreover, we aim to evaluate the potential mediating roles played by both distress disclosure and perceived social support in this dynamic relationship.

Method

All participants completed assessments using the Adolescent Self-Rating Life Events Checklist, Rumination Response Scale, Post-Stress Growth Inventory, Distress Disclosure Index, and Perceived Social Support Scale. Correlation and mediation analyses were conducted using SPSS PROCESS 4 MACRO.

Results

All students reported experiencing mild psychological impacts as a result of negative life events in the past year and displayed moderate levels of PSG. There was no significant correlation observed between the effects of negative life events and PSG. Significant negative correlations were found between trait rumination and distress disclosure, perceived social support, and PSG. Distress disclosure and perceived social support jointly operated as sequential mediators in the relationship between trait rumination and PSG among all the participants. Qualitative analyses revealed different correlation patterns of high- versus low-ruminator.

Conclusion

Trait rumination affects PSG both directly and indirectly, through its influence on distress disclosure and perceived social support. Our results emphasize the significance of actively participating in distress disclosure and nurturing a robust sense of social support to counteract the detrimental effects of rumination on post-stress growth among Chinese college students.