Mental distress among young adults - gender differences in the role of social support

The silent pandemic of stress: impact on menstrual cycle and ovulation

In the current age of technological advancement, stress has emerged as a silent pandemic affecting individuals, especially young generations, globally. Factors such as increased competition, social pressures fueled by social media and smartphones, and a sense of diminished control in the face of modern challenges contribute to rising stress levels. In addition to the negative implications on mental well-being, stress affects physiological processes such as the menstrual cycle. Functional hypogonadotropic hypogonadism is a spectrum ranging ranging from regular menstrual cycles with short or insufficient luteal phases to irregular cycles, oligomenorrhea, anovulation, and complete amenorrhea, depending on how stress variably disrupts gonadotropic-releasing hormone (GnRH) drive. Functional hypothalamic amenorrhea (FHA), the most severe manifestation, is a complex global neuroendocrinopathy with several serious health consequences in addition to amenorrhea and infertility. Concomitant health consequences include bone loss, endothelial dysfunction, and cardiovascular risks. The collective health burden underscores the need for clinical awareness and comprehensive treatment strategies addressing behavioral and biopsychosocial stressors that lead to chronic hypothalamic-pituitary-adrenal (HPA) axis activation. Despite its prevalence and numerous adverse health consequences, research on this condition remains limited, revealing a significant gap in understanding and addressing this condition. Larger and long-term follow-up studies are important to accurately assess FHA prevalence, its health consequences, intervention efficacy, and recovery outcomes.

The role of "Social" in the TSST: Social support and social motives partly moderate psychobiological stress responses in addition to biological sex

Prior research has highlighted sex differences in psychobiological stress responses during the Trier Social Stress Test (TSST). This study expands on these findings by exploring how social motives (affiliation and power motives) and social support, as direct predictors and in interaction with biological sex, influence stress responses and reproductive hormones. A sample of 204 participants (108 women, 96 men) underwent the TSST, with social support being manipulated. The biological and psychological responses followed patterns previously documented in the literature. Linear mixed-effect models indicated that biological sex moderated the trajectories of RMSSD, testosterone, progesterone, and well-being across the TSST phases. Additionally, cortisol responses were more pronounced in men, particularly those with strong power motives. Participants receiving social support exhibited lower estradiol levels during the TSST recovery phase compared to the control group. These findings suggest that the impacts of social stress are shaped by complex interactions between biological and social factors, which could be considered in tailored stress interventions.

Dutch translation and validation of the Stanford Gender-Related Variables for Health Research questionnaire: Associations with lifestyle and mental health

This study aimed to validate the Dutch version of the Stanford Gender-Related Variables for Health Research (GVHR) questionnaire and explore sex differences in lifestyle factors, mental health, and health status. In 2021, 569 Dutch participants (54% women, 45% men, aged 20-80) completed the survey. Sex-stratified analyses examined associations with lifestyle (obesity, smoking, alcohol use, physical activity), mental health (depression, anxiety, stress), and overall health status. A seven-factor model best fit the data, revealing significant gendered differences. Women reported higher caregiver strain, discrimination, and emotional intelligence, while men reported more social support and risk-taking. In women findings were more pronounced, and caregiving strain was linked to psychological distress, whereas emotional intelligence and social support were protective. For men, gender discrimination was associated with smoking, depression, anxiety, stress, and poorer health status. The GVHR effectively assesses gender-related behaviors in Dutch samples, though further validation is needed in more diverse populations.

Character strength patterns, social support and psychological distress in adolescents and young adults with cancer: A multicenter cross-sectional study

Objective

Adolescents and young adults with cancer (AYAC) experience severe psychological distress worldwide. Social support was associated with reduced distress among cancer patients, but the role of character strength patterns in this association is unexplored. This study explored whether character strength patterns influence the association between social support and psychological distress in AYAC.

Methods

A multicenter cross-sectional study was conducted at four hospitals in Changsha, China. Participants completed questionnaires assessing sociodemographic, distress, social support, and character strengths. Latent profile analysis determined character strength patterns, and multiple linear regression models examined the association. Interaction terms tested moderation effects, and adjusted models examined confounding, all stratified by gender.

Results

Among 728 participants, three character strength patterns emerged: low (LCS), moderate (MCS), and high (HCS). Across all patterns, higher social support was significantly associated with lower distress in AYAC (female: β = -0.124, 95% CI = -0.051 to -0.015; male: β = -0.180, 95% CI = -0.080 to -0.030; P < 0.001). AYAC with MCS and HCS experienced significantly less distress than those with LCS, across both genders. However, the association between character strength patterns and lower distress was stronger in males (MCS: β = -0.384, 95% CI = -1.898 to -1.033; HCS: β = -0.777, 95% CI = -3.420 to -2.495; P < 0.001) compared to females (MCS: β = -0.284, 95% CI = -1.215 to -0.700; HCS: β = -0.593, 95% CI = -2.776 to -2.102; P < 0.001).

Conclusions

Character strength patterns didn't moderate or confound the association between social support and psychological distress, but had stronger protective effects against psychological distress than social support. Higher character strength patterns showed a stronger association with lower psychological distress, especially for males.

Hiding Uncertain Me in the Crowd: Avoidance-Oriented Affiliation Defense to Self-Uncertainty

Purpose

This study explored how individuals cope with self-uncertainty by subconsciously affiliating with groups. Specifically, we investigated whether this affiliation is driven by avoiding isolation rather than pursuing group identity or entitativity.

Methods

In Study 1, we recruited 50 undergraduate students and employed the Affect Misattribution Procedure (AMP) to measure implicit attitudes toward affiliation and isolation after inducing self-uncertainty. In Study 2, 70 participants were presented with images of abstract human avatars representing different group sizes to assess their preference for group affiliation under conditions of induced self-uncertainty.

Results

Study 1 revealed that individuals experiencing self-uncertainty exhibited a significantly more negative implicit attitude towards isolation than affiliation, with no significant positive shift towards group affiliation. Study 2 further supported these findings by demonstrating a pronounced tendency for self-uncertain individuals to prefer larger, cohesive groups (affiliation) and to report greater feelings of safety within such groups, indicating avoidance of isolation as a critical driver.

Conclusion

The findings suggest that individuals experiencing self-uncertainty instinctively seek refuge in groups as a defense mechanism against isolation rather than for identity validation. This avoidance-oriented affiliation underscores a fundamental psychological process for managing self-uncertainty, highlighting the importance of social proximity in alleviating feelings of insecurity.

Relationship Between Family and Friend Support and Psychological Distress in Adolescents

OBJECTIVE

This study examines the associations between family and friend support and depressive and anxiety symptoms among adolescents, considering potential sex differences.

METHODS

Secondary data from a longitudinal cohort study of 1,348 adolescents ages 11-17 were analyzed using descriptive statistics and multiple linear regression, controlling for relevant factors. Interaction terms between sex and support were created to examine moderation by sex.

RESULTS

Youth who reported higher family support reported lower depressive symptoms (b = -0.53, p < .001) and lower anxiety symptoms (b = -0.39, p < .001). Similarly, youth's higher reported friend support was associated with lower depressive symptoms (b = -0.52, p < .001) and lower anxiety symptoms (b = -0.44, p < .001). Effects were not modified by sex.

CONCLUSION

Understanding modifiable factors such as supportive systems is important to mitigate mental health disorders. Further investigation of protective factors for promoting adolescent mental health is needed.

The Norwegian Counties Public Health Survey (NCPHS): a design study

BACKGROUND

Effective public health initiatives should be founded on a comprehensive and robust understanding of health-related factors including societal and community contexts. The Norwegian Counties Public Health Survey (NCPHS) aims for insights into the adult population on topics relevant for planning public health practices at county and municipality levels.

METHODS

The NCPHS includes a core questionnaire on public health-related topics and demographics, including indicators of socio-economy, with additional optional questions and scales varying across data collections. Samples are drawn from the Norwegian National Population Register and 'washed' against the Common Contact Register to retrieve digital contact information and exclude those who cannot be contacted electronically. NCPHS was piloted in 2015 and 2018 (four counties). After some revision of instruments and sampling procedures, surveys have been carried out in most Norwegian counties since 2019. The total number of participants has now passed 400,000.

RESULTS

Expedient data analysis has enabled the Norwegian Institute of Public Health to present comprehensive reports within 6 weeks of completed data collections. In these, outcome variables are analysed against district (within counties), gender, age, educational attainment and self-reported sufficiency of household income. Tables are also made available at the municipality level.

CONCLUSIONS

The NCPHS represents a valuable addition to existing data sources, providing critical information for planning purposes for local and regional public health authorities, for assessing trends over time, comparisons across counties and regions and for evaluation of policies and interventions. The value of such a system during times of crisis was demonstrated during the COVID-19 pandemic.

Sex Differences in Subclinical Psychotic Experiences: The Role of Daily-Life Social Interactions

BACKGROUND AND HYPOTHESIS

Sex differences in psychosis are reported across the psychosis spectrum, including in subclinical stages. An important factor in understanding these variations is the subjective experience of everyday social interactions (SI). We investigated whether the presence of psychotic experiences (PEs), as well as associated distress, differs between men and women. We focused on the role of daily-life SI quality and whether its association with PEs varies by sex.

STUDY DESIGN

We included adolescents from SIGMA, a general youth population study in Flanders, Belgium (n = 344; mean age = 18.7; 63.4% female). Psychotic experiences were measured using the PQ-16. We used Experience Sampling Methodology to assess daily-life SI. A multilevel model and multiple linear regressions were used to assess, respectively, the relationship between sex and SI quality and whether PEs and their association with SI quality differ between young men and women.

STUDY RESULTS

The results of the multilevel linear regression model indicate that the prevalence of and distress associated with PEs were higher in women. No significant difference was observed in the subjective quality of daily SI. Social interaction quality was strongly related to PEs. This association did not seem to vary for the prevalence of PEs, though women's distress about PEs appeared to be more affected by SI quality.

CONCLUSIONS

Present findings highlight the role of the subjective quality of SI in subclinical psychosis. More research is needed to investigate the mechanisms through which SI quality relates to PEs, and whether these differ between young men and women.

Mental distress and associated factors among undergraduate students: evidence from a cross-sectional study at the University of Dodoma, Tanzania

Mental distress is a common health problem facing university students worldwide. It manifests with varying levels of depression, anxiety, and somatic symptoms such as headache, backache, sleeping problems, and fatigue. University students are a high-risk group for mental distress than the general population. This study aimed to assess knowledge, the prevalence of mental distress, and its associated factors among undergraduate students. A cross-sectional study was conducted among undergraduate students at the University of Dodoma in Tanzania. Data were collected using pre-tested and self-administered questionnaires. Bivariate and multivariable logistic regression models were used to identify factors associated with mental distress. A total of 224 undergraduate students gave a complete response, of which the majority were aware of the common symptoms of mental distress. Self-reported mental distress experience was reported among 116/224 (51.8%) students. Multivariable logistic analysis showed that only alcohol consumption (aPR = 1.61, 95% CI 1.22-2.11, p = 0.001) was independently associated with mental distress among students. The findings of this study revealed that undergraduate students had adequate knowledge of the symptoms of mental distress. Our results show that the prevalence of self-reported mental distress was moderately high among undergraduate students. Furthermore, the study indicates a significant association between alcohol consumption and self-reported mental distress among these students. These results suggest that interventions aimed at reducing alcohol consumption may be beneficial in mitigating mental health issues among undergraduate students in Tanzania.

From Clicks to Calm: Investigating the Link Between Mindfulness and Digital Hoarding Behavior Among Chinese Youth

Background

Digital hoarding refers to the continuous acquisition of digital content and the difficulty in disposing of it. This behavior is increasingly common among today's youth. This study aims to explore the impact of mindfulness on digital hoarding behavior, investigating self-control as a mediator and upward social comparison via social media as a moderator.

Methods

A total of 956 young individuals participated in this cross-sectional study. The research instruments used included the Mindfulness Measure, the Self-Control Scale, the Social Comparison Scale, and the Digital Hoarding Behavior Questionnaire. Data analysis included descriptive statistics and correlation analysis. For more complex analyses, we examined the mediating role of self-control and the moderating effects of upward social comparison via social media in the relationship between mindfulness and digital hoarding behavior.

Results

1) Mindfulness significantly negatively predicted digital hoarding. 2) Self-control mediated the relationship between mindfulness and digital hoarding. 3) Upward social comparison via social media moderated the relationship between mindfulness and self-control, specifically the first segment of the mediation pathway.

Discussion

This research is pioneering in exploring mindfulness as a protective factor against digital hoarding, offering fresh insights into this nascent field. The findings also suggest prevention and intervention strategies for digital information management disorder in young people.

The role of social support in the relation between chronotype and mental health in a cohort of women from the American Heart Association Go Red for Women Strategically Focused Research Network

Women are disproportionally affected by psychological distress and lack of social support and are more vulnerable to the negative impact of chronotype on mental health. This study evaluates cross-sectional associations between chronotype and mental health, while assessing the mediating role of social support among women from diverse racial/ethnic backgrounds. Women from the American Heart Association Go Red for Women Research Network were included (N = 506, mean age = 37 ± 15.7, 61% racial/ethnic minority). Chronotype, depression, perceived stress, health-related quality of life, and social support were assessed at baseline using validated self-reported questionnaires. Linear regression and causal mediation analyses were performed. Depression and negative emotionality were higher among women with evening vs. morning/intermediate chronotypes (all p < 0.05). Multivariable analyses adjusted for sociodemographic and clinical confounders showed associations between evening chronotype and higher depression (p = 0.004) and negative emotionality (p = 0.010). However, these associations were no longer significant after adjusting for social support (depression: p = 0.12; negative emotionality: p = 0.18). Social support significantly mediated 44.6% and 45.8% of the total effect of chronotype on depression and negative emotionality, respectively. Social support represents a potential mechanism underlying the associations between eveningness and poor mental health. Chronotype and social support should be considered in interventions for the promotion of mental health in women.

Symptoms of depression and anxiety in young people in El Salvador: Associations with peer and family relationships, artistic activities and health behaviours during the COVID-19 pandemic

BACKGROUND

Little is known regarding the correlates of mental health, during the COVID-19 pandemic, in lower income countries. Using data from almost the entire population of graduating high school students in El Salvador, we examine the associations between depression and anxiety symptoms and potentially protective factors including peer and family relationships, health behaviours and artistic leisure activities.

METHODS

Data comes from the AVANZO survey conducted in El Salvador with 42,314 graduating high school students aged 15-21 in November 2020. Participants completed the Revised Child Anxiety and Depression Scale and Socioemotional Skills Scale. Using a structural equation modelling framework, we tested the associations between these variables and whether these associations varied by sex.

RESULTS

Participants who experienced more positive family relationships reported fewer symptoms of depression (β = -0.304, p < .001) and anxiety (β = -0.103, p < .001). Similar results were found between health behaviours and symptoms of depression (β = -0.398, p < .001), and anxiety (β = -0.312, p < .001). Peer relationships were non-significantly associated with depression and anxiety symptoms. Associations were similar for boys and girls.

LIMITATIONS

Students undertook the mental health survey as part of an academic test, which might have increased mental stress. The Socioemotional Skills Scales is newly developed, and results are cross-sectional.

CONCLUSIONS

Our findings provide insight into the experiences of an understudied population during the pandemic and identify positive family relationships and health behaviours as important correlates of mental health during this time.

Socioeconomic Status, Protective Factors, and Mental Health Problems in Transition from Adolescence to Emerging Adulthood: Results of the Longitudinal BELLA Study

Lower familial socioeconomic status (SES) is associated with more mental health problems in adolescence. The aim of this study was to identify factors that may protect adolescents from families with lower SES from developing mental health problems in emerging adulthood. Data of the population-based longitudinal BELLA study included n = 426 participants aged 13 to 17 years at t0 (2009-2012) and 18 to 24 years at t1 (2014-2017). Hierarchical multiple linear regressions with interaction terms were conducted, examining three selected protective factors (self-efficacy, family climate, and social support). Self-efficacy had a small protective effect for adolescents from families with lower SES for mental health problems in emerging adulthood. However, social support had a small protective effect for adolescents from families with higher SES. No moderating effect was found for family climate. Instead, better family climate in adolescents predicted fewer mental health problems in emerging adulthood with a small effect regardless the SES in adolescence. Results indicate the need for prevention measures for adolescents from families with lower SES for becoming mentally healthy emerging adults.

Gender differences in sense of coherence among university students during the COVID-19 pandemic in Turkey

Non-pharmaceutical interventions (NPIs) implemented to mitigate the COVID-19 pandemic halted everyday life in higher education along with social and psychological impacts. The objective of our study was to explore the factors related to sense of coherence (SoC) from a gender perspective among university students in Turkey. This is a cross-sectional survey conducted online with a convenience sampling method as part of the international COVID-Health Literacy (COVID-HL) Consortium. SoC was measured by a nine-item questionnaire that was adapted to the Turkish language, including socio-demographic information and health status, including psychological well-being, psychosomatic complaints, and future anxiety (FA). 1595 students from four universities, of whom 72% were female, participated in the study. Cronbach's alpha for the SoC scale was 0.75. Based on the median split of the individual scores, levels of SoC showed no statistically significant difference according to gender. Logistic regression analysis indicated that higher SoC was associated with medium and high subjective social status, studying in private universities, high psychological well-being, low FA, and none/one psychosomatic complaint. While results were similar among female students, type of university and psychological well-being showed no statistically significant association with SoC among males. Our results indicate that structural (subjective social status) and contextual (type of university) factors, along with gender-based variations, are associated with SoC among university students in Turkey.

Mental health problems among transition-aged youth with physical disabilities: an initial evaluation

Aim

Decreased participation and complex transitions into adulthood among youth with disabilities may impede their well-being. To advance knowledge on the co-occurrence of mental health problems and physical disability, this brief report describes the frequency of mental health problems, measured by the Behavior Assessment System of Children (BASC-3), among transition-aged youth (14-25 years) with physical disabilities and examines the association between mental health problems and sex, age, and number of functional issues.

Methods

Thirty-three participants completed a demographic questionnaire and the BASC-3. Frequency of BASC-3 scales falling within 3 categories: "within norms", "at risk", and "clinically significant" were described. Crosstabs and Chi-square tests were used to examine the association between BASC-3 scales and sex, age (< and ≥ 20), and number of functional issues (< and ≥ 6).

Results

Overall, "somatization", "self-esteem", "depression" and "sense of inadequacy" were the most common subscales being at risk. Participants with a higher number of functional issues (≥6) were more likely to fall within "at risk" or "clinically significant" categories across 20 (out of 22) BASC-3 scales, and female participants tended to fall more within "at risk" or "clinically significant" categories for 8 of BASC-3 scales. Younger participants (<20) were ranked in the "at risk" or "clinically significant" categories for 7 scales.

Conclusions

Findings lend further support for the occurrence of mental health problems emerging in youth with physical disabilities and highlight initial trends especially across functional levels. Further investigation of such co-occurrences and the factors that affect their development is needed.

Point prevalence and sex-specific associated factors of depression in Latvian general population

Background

This cross-sectional study aimed to determine the current prevalence of depression, and analyze sex-specific associated socio-demographic and health-related factors for depression in a representative sample of the general adult population of Latvia.

Methods

Specially trained professional interviewers conducted computer-assisted face-to-face interviews with a multistage stratified probability sample from the general Latvian adult population (n = 2,687). A 9-item Patient Health Questionnaire (PHQ) was used for assessment of depression. Respondents were interviewed using the specially developed questionnaire about sociodemographic factors as well as the alcohol use disorder module of the Mini International Neuropsychiatric Interview. Binary logistic regression was used to calculate the odds ratios (OR) for the univariate and multivariate logistic analyses.

Results

The point prevalence of depression according to the PHQ-9 was 6.4% (95% CI 5.8-7.6). After adjustment for all independent variables analyzed, being divorced, widowed, or living separately increased the odds of depression [aOR 2.6 (95% CI, 1.2-5.8), p = 0.02] in males. For females, unfinished primary education [aOR 5.2 (95% CI 2.0-13.6), p = 0.001] and economically inactive status [aOR 2.0 (95% CI, 1.1-3.6), p = 0.03] were strongly associated with depression.

Limitations

The cross-sectional design of the study did not allow us to draw conclusions about causality. Patients with bipolar, organic, and symptomatic depression states were not excluded.

Conclusion

The prevalence of depression in the general adult population is 6.4%, with the most significant sex-specific factors associated with depression for males - being divorced, widowed, or living separately, and for females it was poor education and economic inactivity.

A study of socio-economic inequalities in self-reported oral and general health in South-East Norway

This study assesses the association between socioeconomic determinants and self-reported health using data from a regional Norwegian health survey. We included 9,068 participants ≥ 25 years. Survey data were linked to registry data on education and income. Self-reported oral and general health were separately assessed and categorized into ‘good’/‘poor’. Exposures were educational level, personal income, and economic security. Prevalence ratios (PR) were computed to assess the associations between socioeconomic determinants and self-reported health using Poisson regression models. Participants with low education or income had poorer oral and general health than those with more education or higher income. Comparing the highest and lowest education levels, adjusted PRs for poor oral and general health were 1.27 (95%CI, 1.11–1.46) and 1.43 (95%CI, 1.29–1.59), respectively. Correspondingly, PRs for lowest income quintiles compared to highest quintile were 1.34 (95%CI, 1.17–1.55) and 2.10 (95%CI, 1.82–2.43). Low economic security was also significantly associated with poor oral and general health. There were socioeconomic gradients and positive linear trends between levels of education and income in relation to both outcomes (P-linear trends < 0.001). We found statistical evidence of effect modification by gender on the association between education and oral and general health, and by age group between income and oral health.