Delayed-Onset PTSD and Coping Strategies of Chinese College Students During the COVID-19 Pandemic

The prevalence of posttraumatic stress disorder and its correlation with health beliefs among medical students

BACKGROUND

Prolonged exposure to chronic stressors, such as the ongoing COVID-19 pandemic, heightens the likelihood of experiencing various physical and mental health complications, including developing posttraumatic stress disorder (PTSD). The objective of the current study was to assess the prevalence of PTSD and examine its association with health beliefs among students enrolled in the Shahroud University of Medical Sciences.

MATERIALS AND METHODS

This cross-sectional study was conducted in 2022 and involved 350 students from diverse medical sciences. The participants were selected using a multistage stratified random sampling method. The study utilized health belief and PTSD questionnaires to collect data. The data were analyzed using analysis of variance (ANOVA), Chi-square, and multiple regression models.

RESULTS

The average PTSD score among students was 43.3 ± 13.1. It was shown that 81 (23.8%) individuals had a lower score of PTSD. Furthermore, 161 (47.3%) were determined to have moderate levels of PTSD, while 99 (29%) had severe levels of PTSD. The average health beliefs score was 97.4 ± 15.0 out of 184, indicating moderate health views. The findings show a correlation between more outstanding total scores on health behaviors and a lower average score on PTSD. Regarding variables, it was discovered that Ph.D. and professional doctorate students had higher PTSD ratings than undergraduate students. Individuals with weaker economic means had a 4.6-point higher average PTSD score than those with a monthly income exceeding $300. Furthermore, people with moderate to high anxiety levels due to COVID-19 had a considerably higher average PTSD score, roughly 13.3 higher, than those who experienced lower stress levels.

CONCLUSION

The findings indicate a negative correlation between the total score of health behaviors and the average score of PTSD. Furthermore, the variables of educational level, impoverished economic status, and anxiety induced by the COVID-19 pandemic emerged as significant predictors of elevated scores on the PTSD scale. In order to increase psychological health and reduce PTSD in students, this research suggests teaching health principles in the context of COVID-19.

Mental health status and coping strategies of Chinese university students during the COVID-19 pandemic: A rapid review

Since the coronavirus (COVID-19) outbreak in December 2019, students have been under unparalleled psychological stress worldwide. As part of its prevention and control strategies, the Chinese Ministry of Education proposed online teaching activities for universities. For the first time, teaching and learning shifted completely online, significantly impacting university students used to classroom learning. This research addresses the knowledge gap about the mental health and coping strategies employed by Chinese university students during the COVID-19 pandemic. Electronic databases (PsycINFO, Scopus, Medline, Cochranes and CNKI) were searched systematically from 2019 to 2023, as part of this literature review. From the 349 articles found, 25 met the inclusion criteria for analysis. Thematic analysis was used to identify six sub-themes, organized under two main themes: Mental health issues of Chinese university students and their coping mechanisms. Heightened stress, anxiety, and depression appeared in Chinese university students during the pandemic, which may have been compounded by their isolation and the disruptions to their studies. Although the impact of COVID-19 on Chinese university students is waning, this study emphasizes the potential long-lasting impact on their mental health, which requires further investigation, particularly regarding gender differences. Moreover, positive and negative coping strategies were found in this review. Strategies for seeking social and family support and participating in sports activities had significant alleviating effects, while negative coping strategies such as alcohol-use and smoking did not. This rapid review informs the development of policies and interventions to enhance the mental health of university students during crisis events. The findings serve to inform health policymakers, university psychologists, and educators in improving the well-being of this student population.

The Switch to Online Learning during the COVID-19 Pandemic: The Interplay between Personality and Mental Health on University Students

The switching from traditional to online learning during the COVID-19 pandemic was challenging for students, determining an increase in physical and mental health problems. The current paper applied a two-step cluster analysis in a large sample of n = 1028 university students (Mage = 21.10 years, SD = 2.45 years; range: 18-30 years; 78.4% females). Participants responded to an online survey exploring neuroticism, trait/state anxiety, general self-efficacy, academic motivation, fear of COVID-19, the impact of the COVID-19 pandemic on physical and mental health, and the help requests. Results showed two significant clusters of students having a Maladaptive Academic Profile (n = 456; 44.4%) or an Adaptive Academic Profile (n = 572; 55.6%). Significant differences were found between the two clusters, where students belonging to the Maladaptive Academic Profile reported higher levels of neuroticism, higher dispositional and situational anxiety, and fear of COVID-19, and lower self-efficacy and academic motivation than students of the Adaptive Academic Profile cluster. In addition, more physical or mental health problems and help requests, mainly to partners during the COVID-19 pandemic, were found in the Maladaptive Academic Profile cluster compared to the Adaptive Academic Profile. Finally, the practical implications of the study's results in implementing university counseling services as protective measures to contrast psychological distress in the long-term COVID-19 pandemic are discussed.

Routine laboratory parameters predict intensive care unit admission and hospitalization in patients suffering stab injuries

Background

Knife crime has increased considerably in recent years in Northern Europe. Affected patients often require immediate surgical care due to traumatic organ injury. Yet, little is known about clinically relevant routine laboratory parameters in stab injury patients and how these are associated with intensive care unit (ICU) admission, hospitalization and number of surgeries.

Methods

We retrospectively analyzed 258 stab injury cases between July 2015 and December 2021 at an urban Level I Trauma Center. Annual and seasonal incidences, injury site, injury mechanism, Injury Severity Score (ISS), and surgical management were evaluated. First, correlations between routine laboratory parameters for hematology, coagulation, and serum biochemistry (peak, and Δ (change from admission to peak within 3 days following admission)) and length of hospital stay, ICU stay, and number of surgeries were assessed using Spearman's rank correlation coefficients. Second, multivariable Least Absolute Shrinkage and Selection Operator (LASSO) regression analyses were conducted to identify parameters predictive of clinical outcomes. Third, longitudinal developments of routine laboratory parameters were assessed during hospital admission.

Results

In 2021, significantly more stab injuries were recorded compared with previous years and occurred less during winter compared with other seasons. Mean ISS was 8.3 ± 7.3, and ISS was positively correlated with length of hospital and ICU stay (r = 0.5-0.8, p < 0.001). Aspartate transaminase (AST) (Δ) (r = 0.690), peak C-reactive protein (CrP) (r = 0.573), and erythrocyte count (Δ) (r = 0.526) showed the strongest positive correlations for length of ICU stay for penetrating, thoracoabdominal, and organ injuries, respectively. No correlations were observed between routine laboratory parameters and number of surgeries. For patients with penetrating injuries, LASSO-selected predictors of ICU admission included ISS, pH and lactate at admission, and Δ values for activated partial thromboplastin time (aPTT), K+, and erythrocyte count. CrP levels on day 3 were significantly higher in patients with penetrating (p = 0.005), thoracoabdominal (p = 0.041), and organ injuries (p < 0.001) compared with those without.

Conclusion

Our data demonstrate an increase in stab injury cases in 2021 and an important link between changes in routine laboratory parameters and ICU admission and hospitalization. Monitoring ISS and changes in AST, CrP, erythrocyte count, pH, lactate, aPTT, and K+ may be useful to identify patients at risk and adjust surgical and ICU algorithms early on.

Longitudinal Shifts in Movement Behaviors during the COVID-19 Pandemic: Relations to Posttraumatic Stress Disorder among University Students

This study examined the longitudinal changes of movement behaviors and their relationships with posttraumatic stress disorder (PTSD) among university students during the coronavirus disease 2019 in China. A total of 569 university students completed online surveys twice (Time 1: between December 2020 and January 2021; Time 2: between November and December 2021). Physical activity, sedentary behavior, sleep duration and quality, as well as PTSD were self-reported. According to Canadian 24-h movement guidelines, the longitudinal shifts in each movement behavior from Time 1 to Time 2 were divided into four categories (consistently meeting the guidelines, from meeting to not meeting the guidelines, from not meeting to meeting the guidelines, and consistently not meeting the guidelines). Generalized linear mixed models were conducted using 410 valid responses (20.2 ± 1.0 years old at Time 2, 41.2% males). From Time 1 to Time 2, 22.2%, 2.0%, and 45.6% of the students consistently met the physical activity, sedentary behavior, and sleep guidelines, respectively. Compared to those who consistently met the sedentary behavior guideline, students who consistently failed to meet or changed from meeting to not meeting the guidelines had higher levels of PTSD. Students who had poor sleep quality at both time points or changed from good to bad sleep quality had higher levels of PTSD than those who maintained good sleep quality over time. Compared to those who consistently failed to meet the guideline, students who consistently met the PA guideline had higher levels of PTSD. These findings highlight the needs to improve and maintain healthy behaviors for mental health.

The Association between Post-Traumatic Stress Disorder and Psychological Distress among Primary School and Middle School Teachers during the COVID-19 Epidemic: A Moderated Mediation Analysis

Background: The outbreak of the coronavirus disease (COVID-19) and its rapid spread may have led to individuals developing post-traumatic stress disorder (PTSD) and psychological distress. Under this context, teachers merit more attention as a group with high levels of work stress. The purpose of this study was to verify the relationship between PTSD and psychological distress and to explore sleep problems as a possible mediator in the relationship between PTSD and psychological distress, as well as the moderator of internet gaming disorders (IGD) in the relationship between sleep problems and psychological distress. Methods: A total of 11,014 Chinese primary and middle school teachers participated in this study. The survey was conducted online between 25 May and 30 June 2020. Results: PTSD was shown to have both a direct and indirect effect on teachers’ psychological distress. The indirect effect was mediated by sleep problems. IGD played a moderating role between sleep problems and psychological distress. Conclusions: During the COVID-19 pandemic, PTSD has been shown to have had a serious impact on the psychological stress of teachers, which was mediated by sleep problems. In addition, IGD raised the harm brought from sleep problems on teachers’ mental health.

Coping Strategies and Trauma-Related Distress of College Students During Covid-19

Present-day college students are particularly impacted by the disconcerting effects of Covid-19 because of their vulnerability towards mental health struggles. The current study identified coping strategies used by students in the United States and how those strategies are associated with trauma-related distress. Results showed acceptance, emotional processing, and social support were the most commonly used coping strategies. Furthermore, avoidance coping related to higher distress than more helpful approaches (e.g., humor). Demographic findings revealed that Black students used more religious coping than did White and Asian students. Additionally, older and upper-year students used substances to cope more than did other students, including those with higher grade point averages. Our discussion focuses on how the findings of the present study can be used to enhance student support, resiliency, academic performance, and retention.

Psychological Responses and Strategies Towards the COVID-19 Pandemic Among Higher Education Students in Portugal and Switzerland: A Mixed-Methods Study

Background

The COVID-19 pandemic has caused overwhelming changes in individual and community daily-life, resulting from the public health measures implemented to contain it, and also from its psychological and socio-economic consequences. These shifts and consequences impacted the entire population, but some groups are more likely to be affected by these changes, including higher education students.

Objectives

a) to investigate mental health status and its determinants among higher-education students in Portugal and Switzerland; and b) to explore adjustment patterns used by these students to overcome the impact of the COVID-19 pandemic.

Methods

A cross-sectional study with a mixed-methods sequential explanatory design was conducted in two phases. First, an online survey was conducted among higher education students in Portugal and Switzerland, in Portuguese and French respectively. A convenience sampling method was used. Second, some participants from the first phase were invited to participate in four online focus group discussions (two in each country) using a maximum variation sampling method.

Results

The survey was answered by 1,880 students. Portuguese students revealed higher levels of stress and anxiety, but lower depression symptoms and less resilient coping compared to Swiss respondents. Hope was identified as an explanatory variable for mental health symptoms in students from both countries. In the focus groups (n = 27), 13 adjustment strategies were found, which were subdivided into three spheres: personal, social, and contextual.

Conclusions

The results suggest that the COVID-19 pandemic had a mild to moderate impact on most of the evaluated mental health variables. Nevertheless, the students reacted and mobilized positive short-term strategies, which need to be reinforced in order to prevent long-term psychological harm. In addition, our results can inform psychosocial interventions to minimize psychological impact, anxiety, depression, and stress due to sanitary crises or other population-wide problems or disasters.