COVID-19-related future anxiety is associated with the health-related quality of life in school-aged children and adolescents-A cross-sectional study

"We're living in a world that wasn't built for us": A qualitative exploration of young New Zealander's perspectives on socio-ecological determinants of declining youth mental health

BACKGROUND

Globally, youth mental health has been in decline since the beginning of the 21st century. While much has been written about the reasons for this, we have little understanding of young people's perspectives. A rich understanding of the issues young people identify as impacting their mental health is essential for developing effective interventions. This study aimed to explore what young people from Aotearoa, New Zealand believe impacts their mental health, both positively and negatively, with a focus on social determinants.

METHODS

176 young people (16-25-year-olds, mean age 17) participated in one of 19 workshops held in 2023. Our methodology was informed by participatory research methods and developed in consultation with young people who served as advisors. Workshops were held across rural and urban areas of two regions of New Zealand. Recordings were transcribed, combined with survey responses, and analysed through Reflexive Thematic Analysis.

RESULTS

Four themes were identified which young people perceived as impacting their wellbeing: The world we live in, the pressures we experience, the connections we need, and finding our path. All factors identified as impacting on their mental health, both positive and negative, were 'amplified' by social media.

CONCLUSIONS

Our findings highlight the intersecting issues of systemic social determinants of wellbeing and their complex relationship with an evolving digital landscape. Effectively addressing rising rates of mental health challenges is likely to hinge on both population level action to address social determinants and targeted promotion of strategies to support young people to navigate the increasing complexity of modern life.

Future anxiety mediates the relationship between organ donation and transplantation knowledge and health-related quality of life

BACKGROUND

Knowledge about organ donation and transplantation plays a crucial role in shaping individuals' health behaviors and perceptions, potentially impacting their health-related quality of life (HRQoL). Future anxiety, defined as the anticipatory worry individuals experience regarding potential negative events and outcomes in their future, may further influence these outcomes.

AIM

To investigate the effect of such knowledge on HRQoL and to examine whether future anxiety mediates this relationship.

METHODS

A cross-sectional study was conducted with 659 participants aged 18 to 65 years. Participants completed the Organ Tissue Donation and Transplantation Knowledge Scale, the Dark Future Scale, and the European Health Interview Survey-Quality of Life 8. Correlation analyses were performed, followed by Structural Equation Modeling to test the proposed mediation model.

RESULTS

The findings indicated that greater knowledge about organ donation and transplantation was positively associated with higher HRQoL and negatively associated with future anxiety. Future anxiety was negatively correlated with HRQoL. Structural Equation Modeling analysis indicated that knowledge directly enhanced HRQoL and reduced future anxiety. Additionally, future anxiety negatively affected HRQoL, mediating the relationship between knowledge and HRQoL. The mediation effect was significant, as confirmed by bootstrapping (bootstrap coefficient = 0.068, 95%CI: 0.046-0.093).

CONCLUSION

The study concludes that future anxiety partially mediates the positive impact of knowledge about organ donation and transplantation on HRQoL. These results suggest that increasing public knowledge in this area may reduce future anxieties and enhance quality of life.

Future anxiety, depression and stress among undergraduate students: psychological flexibility and emotion regulation as mediators

Introduction

Mental health and wellbeing are fundamental and integral components of healthy functioning, and psychological resources significantly contribute to its maintenance and enhancement. This study aimed to investigate the mediating effects of psychological flexibility and emotion regulation in the association between future anxiety, depression, and stress.

Methods

A total of 528 undergraduate students participated in this study (M = 20.14, SD = 1.76).

Results

The findings of the study showed that future anxiety was negatively associated with psychological flexibility and cognitive reappraisal, and positively associated with expressive suppression, depression and stress. Psychological flexibility and cognitive reappraisal had negative relationships with depression and stress, and expressive suppression had a positive relationship with depression and stress. The associations between future anxiety, depression and stress were mediated by psychological flexibility, cognitive reappraisal and expressive suppression.

Discussion

This study deepened our understanding of the possible mechanisms of depression and stress. For individuals suffering from future anxiety, psychological flexibility and emotion regulation may be a coping strategy that leads individuals to less depression and stress. This study suggests that psychological flexibility and emotion regulation skills are fundamental aspects of psychological health.

The relationship of future anxiety with a multidimensional framework of well-being among undergraduate students: optimism and pessimism as mediators

BACKGROUND

Enhancing and maintaining well-being is of great importance for university students to improve their future lives. Therefore, determining the factors that promote well-being is essential. This study aimed to examine the mediating roles of optimism and pessimism in the association between future anxiety and well-being after controlling gender, age, faculty, and department.

METHODS

1024 undergraduate students participated in the study. The mean age of students was 20.27 years (SD = 2.02). Preliminary analyses were conducted to determine descriptive statistics, Cronbach's alpha coefficients, normality, and correlation coefficients between study variables. Mediation analyses were performed to investigate the mediating roles of optimism and pessimism in the association between future anxiety and well-being.

RESULTS

The results of the study showed that future anxiety was positively associated with pessimism, and negatively associated with optimism, positive emotions, engagement, positive relationships, meaning and accomplishment. Optimism had a positive relationship with the constructs of well-being model, and pessimism had a negative relationship with the pillars of well-being. Optimism and pessimism served as mediators in the link between future anxiety and well-being.

CONCLUSION

The findings of this study indicate that students who are anxious about the future are less optimistic and more pessimistic, which in turn leads to lower well-being. The current study suggests that future-oriented thinking and individual strengths, including optimism, should be incorporated into the mental health management of university administrations to promote the well-being of university students.

EQ‑5D‑Y-3L population norms for children and adolescents in Jiangsu, China

OBJECTIVE

This study aims to establish EQ-5D-Y-3L population norms in Jiangsu, China by conducting a large-scale cross-sectional survey.

METHODS

Children and adolescents aged 9-17 from three cities of Jiangsu Province were selected by multistage stratified random sampling to complete the EQ-5D-Y-3L instrument independently. Population norms for Jiangsu, China were determined by calculating statistics based on age and gender. Logistic and Tobit regression models were employed to explain the relationship between HRQoL and factors such as sociodemographic characteristics/recent acute symptoms (experienced fever/cough/sore throat/diarrhea in the past two weeks).

RESULTS

Three cities yielded 37,574 valid samples (a sample validity rate of 95.4%). The EQ-5D-Y-3L utility values (mean ± SD) were 0.964 ± 0.085 for males and 0.958 ± 0.077 for females. Males scored 85.94 ± 19.62 and females scored 84.83 ± 18.45 on the VAS (mean ± SD), while the percentages of respondents reporting full health ranged from 58.3 to 78.8%. The dimension in which most respondents reported having no problems was "feeling worried, sad, or unhappy" (23.0%). And the lowest HRQoL was shown in the 14-year-old age group. Gender, age, board at school, and BMI were found to have an association with HRQoL. In addition, recent acute symptoms also correlate with some aspects of HRQoL.

CONCLUSIONS

This study established EQ-5D-Y-3L population norms in Jiangsu, China for the first time. These norms will support resource allocation decision-making and be used as a reference for health evaluation studies.

Psychometric properties of the Arabic translation of the Dark Future Scale questionnaire in a non-clinical sample of Arabic-speaking young adults

BACKGROUND

Through the years, studying negative behaviors of the worldwide population seized the spotlight from many researchers who focused on building scales in order the measure the level of worries, fear and even depression of such stressed individuals. By definition, "Future anxiety" (FA) is fueled by negative thoughts leading to intense fear of unknown future events. The Dark Future scale (DFS) measures the level of anxiety experienced towards the future. Our aim was to examine the psychometric properties of a novel Arabic translation of the DFS.

METHODS

A sample of 684 Arabic-speaking young adults (65.6% women) filled the DFS, TEMPS-M (temperaments) and DASS-8 (psychological distress).

RESULTS

Confirmatory factor analyses (CFA) supported a unidimensional model of the DFS score, with all 5 items retained. This scale had good reliability. Moreover, concurrent validity demonstrated significant associations between DFS scores and psychological distress, depressive, cyclothymic, irritable and anxious temperament. Scores achieved scalar invariance across gender, with women having greater exposure to anxiety about the future.

CONCLUSION

Overall, these findings led to the conclusion that the Arabic DFS is a psychometrically valid tool for the assessment of FA. The DFS is a brief, reliable and easy to apply scale that would help researchers in psychology and psychiatry in assessing anxiety about future.

Health-related quality of life and impact of socioeconomic status among primary and secondary school students after the third COVID-19 wave in Berlin, Germany

In the earlier phases of the COVID-19 pandemic, studies in Germany and elsewhere found an overall reduction in health-related quality of life (HRQoL) among students. However, there is little evidence on later pandemic stages as well as socioeconomic influencing factors. We aimed to (1) describe HRQoL in a Berlin student cohort at two time points in mid-2021, and to (2) analyze the effects of household income and education. We assessed HRQoL of students from 24 randomly selected primary and secondary schools in Berlin, Germany, with the KIDSCREEN-10 index in June and September 2021. To adjust for non-response bias, inverse probability weighting was applied. The potential effects of both household income and education (lower vs. higher) were estimated in generalized linear mixed models, based on prior assumptions presented in directed acyclic graphs. Our cohort comprised 660 students aged 7-19 years. In June 2021, 11.3% [95% CI = 9.0% - 14.0%] reported low HRQoL, whereas in September 2021, this increased to 13.7% [95% CI = 11.1% - 16.5%], with adolescent girls more frequently reporting low HRQoL at both time points (20% [95% CI = 17.1% - 23.3%] and 29% [95% CI = 25.5% - 32.5%]) compared to boys and younger children. While there was no statistically significant total effect of lower household income on HRQoL, a negative effect of lower household education was statistically significant (β = -2.15, SE 0.95, 95% CI = -4.01 to -0.29, p = 0.024). In summary, students' HRQoL in mid-2021 was better than that documented in other studies conducted at pandemic onset using KIDSCREEN-10. Female adolescents reported low HRQoL more often, and lower household education significantly reduced children's HRQoL. Support strategies for psychosocial wellbeing should consider socioeconomically disadvantaged children as important target groups.

Longitudinal prediction of primary school children's COVID-related future anxiety in the second year of the pandemic in Germany

Although research has confirmed that the first COVID-19-related lockdown has increased stress and mental health problems in children, less is known about the longer-term effects of the pandemic on children's COVID-related future anxiety (CRFA). Because of CRFA's potentially debilitating effects, risk and resilience factors against this anxiety were investigated. To this end, n = 140 children (49% female) in 3rd and 4th grade classrooms in Germany were asked to perform a working memory task and to self-report about their CRFA and emotion regulation in December 2020 and in May 2021. More maladaptive emotion regulation in December 2020 contributed to the explanation of a high CRFA score in May 2021, whereas a better performance on working memory updating contributed a lower CRFA score later when controls were in place. These results were confirmed when children's CRFA in December 2020 was included in the prediction of their later CRFA. They suggest that maladaptive strategies of emotion regulation, such as rumination, may explain higher or increasing levels of CRFA, whereas efficient working memory updating may be an indicator of processing information in a way which shields children from CRFA-related thoughts. The concepts underlying these variables should be included in prevention and intervention efforts.

Connections matter: Adolescent social connectedness profiles and mental well-being over time

INTRODUCTION

This study examined profiles of social connectedness among early adolescents in grade 7 before the COVID-19 pandemic was declared (Winter 2020), and in grade 8 during the second Wave of the pandemic (Winter 2021).

METHOD

Linked data from 1753 early adolescents (49% female) from British Columbia, Canada who completed the Middle Years Development Instrument survey in grades 7 and 8 were used. Participants reported on life satisfaction, depressive symptoms, and connectedness with peers and adults at home, school and in the community. We used Latent Profile Analysis to identify connectedness profiles at both time points, and Latent Transition Analysis to examine transitions in connectedness profiles over time. Multiple regression analyses examined the associations between profile membership in grade 7 and mental well-being in grade 8, and the associations between transitions in profile membership (i.e., increase vs. decrease in connectedness over time) and mental well-being.

RESULTS

Connectedness in multiple domains in grade 7 was related to significantly higher levels of mental well-being in grade 8, controlling for demographics, well-being in grade 7, and COVID-related mental health worries. Well-being was highest when students felt highly connected in all domains and lowest when they felt lower levels of connection. Increases in connectedness were associated with improvements in mental well-being and decreases with a decline in well-being over time.

CONCLUSIONS

Experiencing connectedness with peers and adults is critical for the mental well-being in early adolescence. Providing opportunities to connect is important in the context of major societal challenges such as the COVID-19 pandemic.

Anxiety symptoms and associated factors among school students after 2 years of the COVID-19 pandemic: a cross-sectional study in Zhejiang Province, China

OBJECTIVES

To ascertain the prevalence and associated factors of anxiety symptoms among middle and high school students in Zhejiang after 2 years of the COVID-19 pandemic.

DESIGN

A school-based cross-sectional study.

SETTING

30 counties/districts in Zhejiang Province, China.

PARTICIPANTS

27 019 students attending middle and high schools.

OUTCOME MEASURES

Anxiety symptoms were assessed using the Generalised Anxiety Disorder 7-item scale (GAD-7). A total score of 10 or more is considered indicative of anxiety symptoms.

RESULTS

The overall prevalence (95% CI) of anxiety symptoms was 14.2% (13.4 to 15.0), higher among girls (18.6%, 95% CI: 17.5 to 19.7) than boys (10.2%, 95% CI: 9.5 to 10.9) (p<0.001), higher among rural students (15.1%, 95% CI: 14.1 to 16.2) than urban students (12.5%, 95% CI: 11.6 to 13.4) (p<0.001). Older age (14-15 years, OR=1.25, 95% CI: 1.09 to 1.44; ≥16 years, OR=1.32, 95% CI: 1.07 to 1.63), being girls (OR=1.76, 95% CI: 1.58 to 1.96), living in rural areas (OR=1.14, 95%CI: 1.01 to 1.29), poor academic performance (OR=1.20, 95% CI: 1.03 to 1.41), alcohol drinking (OR=1.15, 95% CI: 1.01 to 1.30), inadequate fruits (OR=1.31, 95% CI: 1.19 to 1.45) and vegetables intake (OR=1.32, 95% CI: 1.10 to 1.57), insomnia (sometimes, OR=2.14, 95% CI: 1.93 to 2.38; often/always, OR=4.73, 95% CI: 4.03 to 5.56), loneliness (sometimes, OR=2.97, 95%CI: 2.59 to 3.41; often/always, OR=8.35, 95% CI: 7.20 to 9.69), sadness (OR=2.51, 95% CI: 2.25 to 2.79) and physical fight (OR=1.29, 95% CI: 1.13 to 1.48) were positively associated with anxiety symptoms, while studying at vocational high school (OR=0.61, 95% CI: 0.49 to 0.75), coming from family with middle income (OR=0.76, 95% CI: 0.64 to 0.89), being physically active 3-7 days weekly (OR=0.85, 95% CI: 0.75 to 0.95) were negatively associated with anxiety symptoms.

CONCLUSION

Anxiety symptoms prevailed among middle and high school students in China. A variety of factors, containing sociodemographic factors, lifestyle behaviours, mental health, academic performance and physical fight should be taken in consideration in addressing prevention and intervention of anxiety symptoms.

How the COVID-19 pandemic shaped adolescents' future orientations: Insights from a global scoping review

Throughout adolescence, youth imagine what the future holds and determine plans to achieve their educational, professional, and personal goals. In this article, we review research that explores how adolescents' future orientations were shaped by the societal unpredictability, physical and mental health risks, and educational disruptions brought on by the COVID-19 pandemic. Findings show that the pandemic, which exacerbated existing societal inequities, also heightened adolescents' social awareness, provoked feelings of uncertainty, and altered adolescents' short- and long-term plans for educational and career prospects. Throughout school building closures and program cancellations, families played a greater role in fostering adolescents' plans. With prospects for more societal uncertainty on the horizon, future directions point toward supporting adolescents in developing adaptable and flexible future orientations.

What predicts the alleviation of Covid-related future anxiety in schoolchildren 6 to 9 months into the pandemic?

Introduction

Although the first COVID-19-related lockdown in the Spring of 2020 has contributed to an increase in mental health problems in many children worldwide, less is known about the longer-term effects of the pandemic on their (future) anxiety. This article examines resilience factors against children's Covid-relatedfut ure anxiety (CRFA).

Methods

N = 140 children (48,6% female) in 3rd and 4th grade classrooms in Northern Germany were asked to self-report about their CRFA, their anxiety, and the social climate in their classrooms in September (T1) and December 2020 (T2).

Results

Results indicate that 18.6% of the children experienced CRFA "often" in at least one item of the CRFA scale at T1. CRFA was more pronounced in girls and in children from immigrant families. Changes in children's CRFA between T1 and T2 were predicted by changes in their anxiety and changes in classroom climate. Children in classrooms with increasing levels of peer support tended to have decreasing levels of CRFA, whereas their agemates' CRFA in less supportive classrooms tended to increase over time.

Discussion

These results suggest that peer and teacher social support may bolster children's resilience against future anxiety in challenging times. Implications for teachers and schools are discussed.

Young People and the Future: School Students' Concerns and Hopes for the Future after One Year of COVID-19 in Austria-Findings of a Mixed-Methods Pilot Study

The COVID-19 pandemic resulted in enormous changes in everyday life and numerous burdens for adolescents. This pilot study focused on how young people look to the future in the face of these burdens. Responses to two open-ended questions on concerns and hopes for the future that were part of a larger online survey on the mental health of school students in Austria were analyzed using qualitative content analysis. Subsequently, differences in the experiences of boys and girls, young people with and without a migration background and psychologically stressed and non-stressed young people were examined by applying a mixed-methods approach. Data collection took place from 3 February to 28 February 2021. From a total survey sample of 3052 adolescents aged 14-20, a representative sample according to gender and migration background (N = 500) was drawn. Qualitative content analysis revealed several areas of concern about the future, including school-related concerns, concerns about the further development of the pandemic and the associated restrictions, concerns related to a lack of locus of control, health-related concerns and concerns about social relationships. The analysis also indicated young people's greatest hopes for the future, such as hopes related to further pandemic development, hopes regarding major life goals, school, social relationships and health. Young people's experiences differ according to gender, migration background and the extent of psychological distress. This study contributes to research on the psychological well-being of adolescents during the pandemic and provides important insights into the subjective experience of young people. It aims to gain a more comprehensive understanding of the concerns and hopes for the future of young people in a time marked by various challenges. The results of the study should be used to develop ideas for measures, such as the expansion of school psychological services and low-threshold support services for students, such as school social work and counseling.

Stress, Coping and Considerations of Leaving the Profession-A Cross-Sectional Online Survey of Teachers and School Principals after Two Years of the Pandemic

Teaching is amongst the six professions with the highest stress levels and lowest job satisfaction, leading to a high turnover rate and teacher shortages. During the pandemic, teachers and school principals were confronted with new regulations and teaching methods. This study aims to examine post-pandemic stress levels, as well as resilience factors to proactively cope with stress and thoughts of leaving the profession among teachers and school principals. We used a cross-sectional online survey. The validated instruments Perceived Stress Scale (PSS-10) and Proactive Coping Subscale (PCI) were used. We included 471 teachers and 113 school principals in the analysis. Overall, respondents had a moderate stress level. During the pandemic, every fourth teacher (27.2%) and every third principal (32.7%) had serious thoughts of leaving the profession. More perceived helplessness (OR = 1.2, p < 0.001), less self-efficacy (OR = 0.8, p = 0.002), and poorer coping skills (OR = 0.96, p = 0.044) were associated with a higher likelihood of thoughts of leaving the profession for teachers, whereas for school principals, only higher perceived helplessness (OR = 1.2, p = 0.008) contributed significantly. To prevent further teacher attrition, teachers and school principals need support to decrease stress and increase their ability to cope.