Family Cohesion and Stress Consequences Among Chinese College Students During COVID-19 Pandemic: A Moderated Mediation Model

Chinese college students' mental health during the first three months of the COVID-19 pandemic: the protective role of family functioning

Background

Various psychological theories suggest that a supportive family environment protects the mental health of young adults during stressful life events. However, evidence is limited regarding the protective role of family support during a major public health crisis.

Objective

To examine the role of family functioning on mental health among Chinese college students during first stage of the COVID-19 pandemic.

Methods

Between January-March 2020, 1,555 college students (44% female, on average 19 years old) from five Chinese universities participated. Participants rated their family functioning on the Family APGAR Index and their mental health on the Psychological Questionnaires for Emergent Events of Public Health, measuring depression, neurasthenia, fear, obsessive-anxiety and hypochondriasis.

Results

Better family functioning was associated with having fewer psychological symptoms. In addition, we identified three mental health profiles related to the severity across the psychological symptoms: Low-level, medium-level and high-level symptom clusters. Latent profile analysis showed that as family function improved, students were, respectively, 16 to 24% more likely to be in the low-level symptom group, compared to being in the medium symptom group or the high-level symptom group.

Conclusion

These results support the notion that family support may act as a psychological buffer for young adults during a large-scale public health crisis like the COVID-19 pandemic.

Comparing the effectiveness of structural family therapy and mindfulness-based family therapy in cohesion and adaptability in couples with marital dissatisfaction

The present study was conducted with the aim of comparing the effectiveness of structural family therapy and mindfulness-based family therapy in cohesion and adaptability in couples with marital dissatisfaction. The research was a semi-experimental study with a pretest-posttest control group design and a two-month follow-up. The research population comprised all couples with marital dissatisfaction who referred to family counseling centers in Tehran (Iran) in the first 6 months of 2021. Out of this number, 30 couples with marital dissatisfaction were selected using convenience and purposive sampling and were randomly assigned to three groups: structural family therapy, mindfulness-based family therapy and the control group. The research tool was the Family Adaptability and Cohesion Evaluation Scale by Olson, Portner and Lavee (1996). In order to analyze the data, repeated measures analysis of variance was used. The findings demonstrated that there is a significant difference between the two experimental groups and the control group in cohesion and adaptability scores. This means that both experimental groups had a significant effect on cohesion and adaptability components (p < 0.05). Further, the results suggested that there is a significant difference between the two experimental groups of structural family therapy and mindfulness-based family therapy in terms of the effectiveness in the components of cohesion and adaptability. Accordingly, the effect of structural family therapy on couple's cohesion and adaptability was greater than that of mindfulness-based family therapy (p < 0.05).

Correlation between childhood trauma experience and depressive symptoms among young adults: The potential mediating role of loneliness

BACKGROUND

It is widely recognized that childhood trauma poses a significant risk of developing depressive symptoms. However, the underlying mediation mechanism between childhood trauma and depressive symptoms requires further exploration.

OBJECTIVE

This study focuses on exploring whether loneliness may act as a potential mediator between childhood trauma and depressive symptoms.

PARTICIPANTS AND SETTING

We analyzed a large sample of college students (N = 7293). Participants completed online questionnaires in the WeChat group.

METHODS

Childhood trauma, depressive symptoms, and loneliness were evaluated using the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Patient Health Questionnaire-9 (PHQ-9), and the University of California Los Angeles Loneliness Scale (UCLA-LS) respectively. The linear regression method was applied to explore the mediating role.

RESULTS

Gender, relationship with family, and left-behind experience are all substantial depressive symptoms risk factors. Childhood trauma was shown to be highly related to depressive symptoms, and this relationship was potentially mediated by loneliness.

CONCLUSIONS

Our research indicates that treating loneliness in those who have undergone childhood trauma may help prevent or treat depressive symptoms. Therefore, loneliness should be taken into consideration while treating and preventing depressive symptoms.

The mediating effect of family health on the relationship between health literacy and mental health: A national cross-sectional survey in China

BACKGROUND

Mental health problems significantly affect people's well-being and result in a huge health burden. Health literacy and family health are critical to reducing people's mental health problems. However, limited studies have addressed their complex interaction. Thus, this study aims to elucidate the mediating effect of family health on the relationship between health literacy and mental health.

METHODS

A national cross-sectional study based on multistage random sampling was conducted from July 10 to Sep 15, 2021, in China. Information about the public's health literacy, family health, and the level of three common mental health problems (depression, anxiety, and stress) was collected. A structural equation model (SEM) was applied to explore the mediating effect of family health on the relationship between health literacy and mental health.

RESULTS

A total of 11,031 participants were investigated. Approximately 19.93 and 13.57% of participants experienced moderate or severe depressive and anxiety symptoms, respectively. The SEM showed that health literacy was directly associated with mental health, with higher health literacy resulting in lower levels of depression (coefficient: -0.018, p = .049), anxiety (coefficient: -0.040, p < .001), and stress (coefficient: -0.105, p < .001). In addition, family health played a significant mediating effect (p < .001) between health literacy and mental health, contributing to 47.5, 70.9, and 85.1% of the total effect of health literacy on personal stress, anxiety, and depression, respectively.

CONCLUSIONS

This study revealed that the improvement of health literacy is directly and indirectly associated with less likelihood of people's mental health problems via family health. Thus, future mental health interventions should be integrated and targeted both at individual level and the family level.

Profiles and predictors of mental health of university students in Hong Kong under the COVID-19 pandemic

This study investigated the mental health problems of university students in Hong Kong and related sociodemographic and psychosocial predictors under the pandemic. A total of 978 undergraduate students (mean age = 20.69 ± 1.61) completed an online questionnaire measuring sociodemographic factors, psychological morbidity, positive well-being, COVID-19 related stress and self-efficacy, and positive psychosocial attributes. Psychosocial risk factors included psychological morbidity, COVID-19 related stress, and difficulties encountered under the pandemic, whereas protective factors comprised pandemic related self-efficacy, positive psychological attributes, positive environmental factors, need satisfaction and positive perception toward service. Results showed that psychological morbidity in the participants was widespread, and it was related to sociodemographic factors, particularly family financial difficulties. While pandemic related stress positively predicted psychological morbidity and negatively predicted well-being indicators, COVID-19 self-efficacy showed an opposite effect. Besides, positive psychological attributes (resilience, emotional competence, and positive beliefs related to adversity) and environmental factors (healthy family functioning, peer support, and supportive community atmosphere) negatively predicted psychological morbidity and positively predicted well-being. Furthermore, need satisfaction and positive perception toward service were negatively associated with psychological morbidity and positively associated with well-being, while perceived difficulties showed an opposite effect.

Home quarantine during COVID-19 blunted childhood trauma-related psychiatric symptoms in Chinese college students

Background

Childhood trauma confers risks to mental health. However, little is known about whether home quarantine (HQ) during the coronavirus disease 2019 (COVID-19) pandemic exaggerated or mitigated the effect of childhood trauma on mental health.

Objective

To examine the modulating effects of prior childhood traumas on the longitudinal changes of psychiatric symptoms in college students before and after HQ during the pandemic.

Methods

This was a two-wave longitudinal study on the mental health of 2,887 college students before and after HQ during the COVID-19 pandemic. The relationships between the changes in the Patient Health Questionnaire-9 (PHQ-9), Symptom Checklist-90 (SCL-90), 16-item Prodromal Questionnaire (PQ-16), Childhood Trauma Questionnaire (CTQ), and Social Support Rating Scale (SSRS) scores were analyzed.

Results

The students with childhood trauma showed a significantly greater decrement in psychiatric symptoms after HQ (F = 17.21, 14.11, 18.87, and 17.42 for PHQ-9, PQ-16 objective and distress, and SCL-90, respectively). The correlation coefficients between the CTQ and these symptoms scales were significant at baseline (r = 0.42, 0.34, 0.37, and 0.39), and decreased after HQ (r = 0.17, 0.20, 0.18, and 0.19). The decrement of depressive, psychotic, and overall symptoms was positively correlated with the scores of the CTQ (r = 0.08-0.27) but negatively correlated with SSRS (r = -0.08--0.14). Multilinear regression analysis confirmed the results of the CTQ and SSRS regarding the modulation of the dynamic changes in psychiatric symptoms. A constructed structural equation model indicated that the total effects of childhood trauma on decreased psychiatric symptoms were partly mediated by lower baseline social support.

Conclusion

Home quarantine during the COVID-19 pandemic could blunt the adverse effects of childhood trauma on mental health, especially for prodromal psychotic symptoms in college students. Changes in relative deprivation and social support may be mediating factors.

Risk factors and digital interventions for anxiety disorders in college students: Stakeholder perspectives

The worldwide prevalence of anxiety disorders among college students is high, which negatively affects countries, schools, families, and individual students to varying degrees. This paper reviews the relevant literature regarding risk factors and digital interventions for anxiety disorders among college students from the perspectives of different stakeholders. Risk factors at the national and societal levels include class differences and the coronavirus disease 2019 pandemic. College-level risk factors include the indoor environment design of the college environment, peer relationships, student satisfaction with college culture, and school functional levels. Family-level risk factors include parenting style, family relationship, and parental level of education. Individual-level risk factors include biological factors, lifestyle, and personality. Among the intervention options for college students' anxiety disorders, in addition to traditional cognitive behavioral therapy, mindfulness-based interventions, psychological counseling, and group counseling, digital mental health interventions are increasingly popular due to their low cost, positive effect, and convenient diagnostics and treatment. To better apply digital intervention to the prevention and treatment of college students' anxiety, this paper suggests that the different stakeholders form a synergy among themselves. The nation and society should provide necessary policy guarantees, financial support, and moral and ethical supervision for the prevention and treatment of college students' anxiety disorders. Colleges should actively participate in the screening and intervention of college students' anxiety disorders. Families should increase their awareness of college students' anxiety disorders and take the initiative to study and understand various digital intervention methods. College students with anxiety disorders should actively seek psychological assistance and actively accept and participate in digital intervention projects and services. We believe that in the future, the application of methods such as big data and artificial intelligence to improve digital interventions and provide individualized treatment plans will become the primary means of preventing and treating anxiety disorders among college students.

Psychometric properties of the traditional Chinese version of the COVID Stress Scales in Hong Kong

Introduction

The COVID Stress Scales (CSS) assess six domains of COVID-19-related stress, including (a) COVID danger, (b) COVID socioeconomic consequences, (c) COVID xenophobia, (d) COVID contamination, (e) COVID traumatic stress symptoms, and (f) COVID compulsive checking. Although the CSS have been validated in various cultural contexts, their psychometric properties in Hong Kong have not been examined. This study endeavors to validate the traditional Chinese version of the 36-item CSS (CSS-36) and the 18-item CSS (CSS-18) in Hong Kong.

Method

Participants were 521 Hong Kong undergraduate students (61% female) aged from 18 to 26 years (M = 20.65, SD = 1.56). An online questionnaire was used for data collection.

Results

The results of confirmatory factor analyses supported a six-factor structure for both the CSS-36 and the CSS-18. Multiple-group confirmatory factor analyses established the gender invariance of the six-factor model for both the CSS-36 and the CSS-18. The CSS-36 and the CSS-18 exhibited good internal consistency reliability and concurrent validity with fear of COVID-19 and negative emotional states.

Discussion

The findings offer evidence for the psychometric properties of the traditional Chinese version of the CSS-36 and the CSS-18 in the Hong Kong context.

The changes in family functioning and family happiness during the COVID-19 pandemic: The situation in Thailand

Background

The effects of the COVID-19 pandemic on family well-being and functioning were generally a concern for healthcare providers in many countries.

Objectives

To explore the changes in family functioning and family happiness during the pandemic in Thailand and to investigate factors associated with the changes in family happiness.

Methods

This was a cross-sectional study conducted between November and December 2021. Online questionnaires regarding family functioning, family happiness, domestic violence, and COVID-19-related experiences were used.

Results

A total of 485 participants were included in this study. The perceived family happiness slightly decreased from 8.19 (pre-pandemic score) to 7.62 (post-pandemic score). In contrast, the general family functioning (SCORE-15 index), strength, and communication subscale scores after the onset of the COVID-19 pandemic were significantly lower than those of the pre-pandemic period. Moreover, the prevalence of verbal and physical violence significantly reduced during the pandemic. In addition, the change in family functioning was the strongest factor associated with the change in family happiness.

Conclusion

In general, family functioning slightly improved; however, perceived family happiness decreased during the pandemic. In addition, the change in family functioning was the strongest factor associated with the change in family happiness.

Family Resilience and the COVID-19 Pandemic: A South African Study

The onset of the COVID-19 pandemic created various challenges for individuals and families across the globe. Many countries went into a state of disaster and applied strict lockdown regulations to limit the spread of the novel coronavirus. Although the sudden changes in livelihoods impacted families globally, this research is limited to understanding how families connected and resolved conflict during the pandemic. The current study therefore aimed at exploring how family dynamics and resilience in South African families were affected by the COVID-19 pandemic. This study was conducted qualitatively in the Western Cape, South Africa, with 31 participants. The results indicated that families in the Western Cape had trouble adjusting to the imposed restrictions; however, some of these families used the time they had together to adapt and find new ways of building their relationships and strengthening their bonds. The main themes indicated that the most difficult challenges were the children’s schooling, financial impact from job losses, and separation from extended family members due to restrictions on movement. Furthermore, familial support and connecting as a family through open and honest communication helped the families remain resilient and fostered positive relationships.

Association between Family Dysfunction and Post-Traumatic Stress Disorder in School Students during the Second COVID-19 Epidemic Wave in Peru

Although the effect of the COVID-19 pandemic on children and adolescents’ mental health has been studied, there is still scarce evidence of the influence of nuclear family on the development of post-traumatic stress disorder (PTSD). This study aimed to determine the association between family dysfunction and PTSD in Peruvian high-school students during the COVID-19 pandemic. A cross-sectional study was conducted using a virtual survey administered to 562 high-school students in three schools in Chiclayo, Peru. The dependent variable was PTSD, which was measured with the Child PTSD Symptom Scale. Family dysfunction was the main independent variable, measured with the Family APGAR Questionnaire. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were estimated with generalized linear models. Most of the students were female (88.3%) and the average age was 14.4 years. We found that 21.4% showed severe family dysfunction and 60.3% had PTSD. Students with mild and moderate family dysfunction had 37% (PR: 1.37; 95% CI: 1.14–1.65) and 26% (PR: 1.26; 95% CI: 1.04–1.54) higher PTSD prevalence, respectively. In conclusion, family dysfunction may influence the development of PTSD in adolescents. This study suggests the importance to develop a healthy family environment to help adolescents face critical situations experienced during the pandemic.

Focus on High School: Factors Associated with Creating Harmony between the Educational Transition and Adolescents’ Well-Being

The transition from online to on-site education was difficult due to a lack of standardized school guidance for school reopening. Even though schools have reopened, uncertainty about the COVID-19 situation and the capacity of the school to maintain safe school operations to mitigate risks may increase hesitancy among students and parents to participate in on-site studying. Rapid-response surveys of students and parents can provide information to stakeholders on how learning and well-being can best be supported during the educational transition in each context. The aim of this study was to explore the hesitancy of high-school students and the factors that influenced their hesitancy to return to school on site. An online cross-sectional survey was distributed to high-school students in an urban district of Chiang Mai, Thailand, during the fourth wave of the pandemic from 17 November to 13 December 2021. A multivariable logistic regression was performed to explore factors related to the students’ hesitancy to attend on-site education. With a response rate of 10.2% of the targeted study population, the 1266 participants revealed that 15.9% of them had very-high- and extremely high-level hesitancy to study on site, which was associated with less negative moods while studying online (aOR, 1.69; p, 0.016) and a greater fear of infection after returning to school (aOR, 2.95; p, 0.001). Increased readiness to return to school on site (aOR, 0.28; p, 0.001) and discussing COVID-19 prevention with family or friends (aOR, 0.71; p, 0.016) were also associated with a lower hesitancy of students. Only 5.6% of the students reported being hesitant to receive the COVID-19 vaccination. However, no significant associations were found between schooling hesitancy and their willingness to get vaccinated, nor the frequency of students’ outside activities. High-school students who experience negative moods during online studying should be monitored and receive additional support if the reopening is postponed. More opportunities to discuss COVID-19 prevention with family or friends, as well as a higher level of readiness, may increase the willingness to return to school on site. Local authorities and schools need to strengthen communication and coordination mechanisms to reduce parents’ and students’ schooling hesitancy by providing explicit information about the COVID-19 situation and risk-mitigation measures, along with normalizing messages about fear and anxiety.

The Predictive Effects of Family and Individual Wellbeing on University Students' Online Learning During the COVID-19 Pandemic

The COVID-19 pandemic has significantly changed university students' life routines, such as prolonged stay at home and learning online without prior preparation. Identifying factors influencing student online learning has become a great concern of educators and researchers. The present study aimed to investigate whether family wellbeing (i.e., family support and conflict) would significantly predict university students' online learning effectiveness indicated by engagement and gains. The mediational role of individual wellbeing such as life satisfaction and sleep difficulties was also tested. This study collected data from 511 undergraduate students (Mean age = 20.04 ± 1.79 years, 64.8% female students) via an online survey. Structural equation modeling analysis revealed positive effects of family support on students' learning engagement and gains through the mediational effects of life satisfaction and sleep difficulties. In contrast to our expectation, family conflict during the pandemic also positively predicted students' learning gains, which, however, was not mediated by individual wellbeing. The findings add value to the existing literature by delineating the inter-relationships between family wellbeing, individual wellbeing, and online learning effectiveness. The study also sheds light on the unique meaning of family conflict, which needs further clarification in future studies.

Staying at Work? The Impact of Social Support on the Perception of the COVID-19 Epidemic and the Mediated Moderating Effect of Career Resilience in Tourism

The COVID-19 epidemic has caused dramatic impacts and changes in the tourism industry, and job insecurity and emotional exhaustion have created psychological stress and negative emotions. Social support for Taiwan tourism workers (travel agency, transportation industry, lodging industry, tourism and leisure industry, etc.) plays an important role in their career resilience. However, not all of the potential social support moderators have a critical impact. This study used PLS-SEM analysis to survey 373 respondents by using an online questionnaire to investigate the critical influence of social support on the spread of COVID-19 using career motivation theory. In addition to the direct relationship between the individual’s psychological resilience and social support, the strategy of social support (family and friends, national relief policies and workplace support) is also pointed out. The results of the study illustrate the effectiveness of workplace support in combating the epidemic. This study provides information on effective resistance to the epidemic, how to prolong career resilience during unexpected shocks and stresses, and how to understand the mechanisms of adaptation or resilience in adversity and complements the study of factors and literature base in resilience research. It is also used as a study of the impact factors and industry strategy planning in future research.

Impacts of Stress and Risk Perception on Mental Health of College Students During the COVID-19 Pandemic: The Mediating Role of Coping Efficacy

OBJECT

In this study, we aimed to explore the influences of pandemic stress, risk perception, and coping efficacy on the mental health of Chinese college students during the COVID-19 pandemic.

METHODS

A nationally representative sample of Chinese college students (N = 3,381, M age = 20.85, SD age = 1.31) took part in an online survey during the COVID-19 pandemic. Correlation coefficients, structural equation modeling, and other statistical analysis methods were used for data analysis.

RESULTS

(1) The Chinese college students' pandemic stress and perceived pandemic risk were found to be moderate (3.51 ± 0.83, 3.45 ± 0.94), whereas their perceived infection risk was lower (2.10 ± 0.67). Their mental health during the COVID-19 pandemic was found to be good (3.80 ± 0.73). (2) The quality of their mental health was significantly and negatively associated with pandemic stress, perceived pandemic risk, and perceived infection risk. The level of their mental health was significantly and positively associated with coping efficacy, and their coping efficacy was significantly and negatively associated with pandemic stress, perceived pandemic risk, and perceived infection risk.

CONCLUSION

Coping efficacy played a partial mediating role in the relationship between pandemic stress and mental health, coping efficacy played a partial mediating role in the relationship between perceived infection risk and mental health, and coping efficacy played a complete mediating role in the relationship between perceived pandemic risk and mental health. Our findings show the importance of fostering college students' coping efficacy to improve their mental health during the COVID-19 pandemic.

COVID-19 Daily Realities for Families: A South African Sample

The COVID-19 pandemic affected families globally. Empirical research has been explored to understand the impact of COVID-19 on families across countries, however, there are limited findings of how COVID-19 has affected the daily realities of families in South Africa. This study used an exploratory qualitative research approach to explore the experiences of COVID-19 for South African families. Findings suggest that the negative outcomes of COVID-19 experienced by South African families included a shift in the daily routines, restrictions on family events, lack of socialization and loss of connections, family conflicts, financial constraints as well as psychological impacts. On the contrary, the positive outcomes included increased family time and communication, cleanliness, and good health status, and improved financial management. Implications for future research should include research focused on the health impacts of COVID-19 on diverse family structures, family compositions, and family dynamics. In-depth research and findings can assist in developing policies and interventions for families.

The Influence of College Students' Empathy on Prosocial Behavior in the COVID-19 Pandemic: The Mediating Role of Social Responsibility

Prosocial behavior has played an irreplaceable role during the COVID-19 pandemic, not only in infection prevention and control, but also in improving individual mental health. The current study was conducted after COVID-19 control was under the stage of Ongoing Prevention and Control in China. Using the Interpersonal Response Scale, Prosocial Tendencies Measure and Big Five Personality Questionnaire. In total, 898 college students participated in the current study (Mage = 19.50, SDage = 1.05, Age range = 16-24). The result showed that against the background of the COVID-19 pandemic, college students' social responsibility partially mediated the relationship between empathy and prosocial behavior. This study provides new insights and inspiration for improving college students' mental health in the context of the pandemic.

Impacts of Stress Response and Negative Emotion on Mental Health of College Students During the COVID-19 Outbreak

OBJECT

In this study, we aimed to explore the influences of stress responses and negative emotion on mental health of college students during the initial COVID-19 outbreak in China.

METHODS

A nationally representative sample of 1,351 college students, aged 18-23 years, took part in an online survey during the COVID-19 outbreak. The ANOVA, correlation coefficients, structural equation modeling (path analysis), and other statistical analysis methods were used for data analysis.

RESULTS

(1) The Chinese college students' epidemic panic and cognitive evaluation were found to be moderate (3.73 ± 0.74, 3.76 ± 0.62), while their defensive response was higher (4.61 ± 0.55). Their mental health during the COVID-19 outbreak was found to be good (3.75 ± 0.76). (2) The quality of their mental health was significantly and negatively associated with epidemic panic, and the quality of their mental health was significantly and positively associated with defensive response. (3) The quality of their mental health was significantly and negatively associated with negative emotion. (4) College students' epidemic panic and defensive response to the COVID-19 had a directly predictive effect on their mental health.

CONCLUSION

College students' negative emotion played a partial mediating role in the relationship between epidemic panic and mental health. College students' negative emotion played a complete mediating role in the relationship between cognitive appraisal and mental health.