Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China
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Abstract
Background
The COVID-19 pandemic has made unprecedented impact on the psychological health of university students, a population vulnerable to distress and mental health disorders. This study investigated psychiatric symptoms (anxiety, depression, and traumatic stress) during state-enforced quarantine among university students in China ( N = 1912) through a cross-sectional survey during March and April 2020.
Results
Psychiatric symptoms were alarmingly prevalent: 67.05% reported traumatic stress, 46.55% had depressive symptoms, and 34.73% reported anxiety symptoms. Further, 19.56% endorsed suicidal ideation. We explored risk and protective factors of psychological health, including demographic variables, two known protective factors for mental health (mindfulness, perceived social support), four COVID-specific factors (COVID-19 related efficacy, perceived COVID-19 threat, perceived COVID-19 societal stigma, COVID-19 prosocial behavior) and screen media usage. Across symptom domains, mindfulness was associated with lower symptom severity, while COVID-19 related financial stress, perceived COVID-19 societal stigma, and perceived COVID-19 threat were associated with higher symptom severity. COVID-19 threat and COVID-19 stigma showed main and interactive effects in predicting all mental health outcomes, with their combination associated with highest symptom severity. Screen media device usage was positively associated with depression. Female gender and COVID-19 prosocial behavior were associated with higher anxiety, while COVID-19 self-efficacy associated with lower anxiety symptoms.
Conclusions
Findings suggest high need for psychological health promotion among university students during the COVID-19 pandemic and inform an ecological perspective on the detrimental role of stigma during an emerging infectious disease outbreak. Interventions targeting multi-level factors, such as promoting mindfulness and social support at individual and interpersonal levels while reducing public stigma about COVID-19, may be particularly promising. Attending to the needs of disadvantaged groups including those financially impacted by COVID-19 is needed.
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SciScore for 10.1101/2020.07.03.20144931: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations: The current study has several limitations. First, although the current study recruited a geographically diverse national sample compared to previous studies on the mental health of Chinese university students restricted to a few universities (Cao et al., 2020; Tang et al., 2020; C. Wang & Zhao, 2020), the open recruitment …
SciScore for 10.1101/2020.07.03.20144931: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations: The current study has several limitations. First, although the current study recruited a geographically diverse national sample compared to previous studies on the mental health of Chinese university students restricted to a few universities (Cao et al., 2020; Tang et al., 2020; C. Wang & Zhao, 2020), the open recruitment method via the internet has its drawbacks. In particular, those highly impacted by COVID-19 may be particularly interested in enrollment and participation, which could upwardly bias estimates of psychiatric symptom severity. Thus, findings may not be representative of the larger Chinese university student population. Second, given the cross-sectional nature of the study, causal directions of the observed relationships cannot be ascertained. For instance, contrary to hypotheses, COVID-19 prosocial behavior was associated with heightened anxiety, and this could be due to those who experience higher anxiety during the pandemic being more likely to engage in prosocial actions as a coping approach. It is also likely that those prone to psychiatric symptoms (e.g., with pre-existing depression or anxiety disorders) may perceive COVID-19 as more threatening. It is crucial that future longitudinal and experimental studies further explore these associations. Third, the Impact of Events Scale (IES) (Horowitz et al., 1979) only measured two clusters of PTSD symptoms (intrusion and avoidance), missing negative alternations in cognition or mood and hyperarous...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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